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

Saturday, June 25, 2016

The Triggers We Don't Notice

By Lisa Ordóñez & David Welsh
Notre Dame Center for Ethical Leadership
Posted in 2016

Many companies’ ethics trainings focus on building frameworks and decision trees as tools for their employees to use in making ethically sound decisions. The assumption is that when these employees are confronted with morally ambiguous situations, the tools will allow them to reason their way through them and figure out the best option.

Based on innovative behavioral research, we now know that it’s not that simple. There are a lot of factors that go into determining whether a decision is ethical or unethical. People need to have the energy and resources to resist the temptation to be immoral. They need to feel like the choice matters and that their behavior will actually make a difference. Perhaps most importantly, people need to frame the situation as an ethical question. It’s not just about the tools to make the right decision when you know it’s a hard one. Employees need to flip on their “ethical switch” if they are going to recognize that there is an ethical question at hand.

The article is here.

Friday, June 24, 2016

Former FDA Commissioner Charged in RICO Lawsuit

The Alliance For Human Research Protection

A Federal Lawsuit charges Dr. Margaret Hamburg, former Commissioner of the Food and Drug Administration (FDA) with conspiracy, racketeering & colluding to conceal deadly drug dangers – under the federal Racketeer Influenced and Corrupt Organizations law (RICO) law. The amended RICO lawsuit was filed on April 11, 2016 in the U.S. District Court in Washington DC on behalf of eight plaintiffs who claim they have suffered severe harm by ingesting the drug, Levaquin whose deadly risks were concealed to protect financial interests.

The drug is one of the controversial group of antibiotics, including  Levaquin, Cipro, Avelox and other fluoroquinolones. Public Citizen petitioned the FDA in 1996 and again in 2006, to issue Black Box warnings for tendon rupture and tendinitis. Had warnings been issued, the death toll from Levaquin– reputedly more than 5,000 — and the tens of thousands who were debilitated with life-threatening diseases would likely have been averted.

The article is here.

War Wounds That Time Alone Can't Heal

by Jane E. Brody
The New York Times
Originally published June 6, 2016

Here are two excerpts:

Therapists both within and outside the Department of Veterans Affairs increasingly recognize moral injury as the reason so many returning vets are self-destructive and are not helped, or only partly helped, by established treatments for PTSD.

Moral injury has some of the symptoms of PTSD, especially anger, depression, anxiety, nightmares, insomnia and self-medication with drugs or alcohol. And it may benefit from some of the same treatments. But moral injury has an added burden of guilt, grief, shame, regret, sorrow and alienation that requires a very different approach to reach the core of a sufferer’s psyche.


(cut)


Therapists who study and treat moral injury have found that no amount of medication can relieve the pain of trying to live with an unbearable moral burden. They say those suffering from moral injury contribute significantly to the horrific toll of suicide among returning vets — estimated as high as 18 to 22 a day in the United States, more than the number lost in combat.


The article is here.

Thursday, June 23, 2016

How to Fix a Broken Mental-Health System

by Norm Ornstein
The Atlantic
Originally published June 8, 2016

Here is an excerpt:

And, for people with the most serious diseases, who cannot recognize they are ill or who have deep psychoses that leave them detached from much of reality, we need to recalibrate the balance between civil liberties and the need to provide real treatment—the kind of wraparound, assisted outpatient treatment (AOT) that Leifman has pioneered in Florida—while making it easier, with appropriate safeguards, for family members to intervene to help their loved ones.

In Washington, the good news is that reforming the system to deal with mental illness is one of the few areas where there is serious bipartisan cooperation and action—including, in the Senate, Democrats like Debbie Stabenow, Chris Murphy, and Al Franken, and Republicans like Roy Blunt, Bill Cassidy, and John Cornyn. In the House, there’s a major bill cosponsored by Republican Tim Murphy, the body’s only psychologist, and Democrat Eddie Bernice Johnson, a former psychiatric nurse.

Of course, there is bad news—this is American politics in 2016. The highly dysfunctional Congress is stymied from action so far even in areas that have broad and deep bipartisan support, like  Puerto Rico’s debt crisis, the opioid crisis, and criminal-justice reform.

The article is here.

“We Didn’t Know”: Silence and Silencing in Organizations

Nina K. Thomas
International Journal of Group Psychotherapy 
DOI:10.1080/00207284.2016.1176489

Abstract

This article examines the dynamic processes within organizations that contribute to systemic silence and silencing and the “we didn’t know” defense, particularly for those groups in which secrecy replaces transparency to the detriment of the organization and its members. The events of the past more than 10 years within the American Psychological Association (APA) surrounding the role of psychologists in interrogation of detainees, including advising on and monitoring interrogations that have been construed as torture, will serve as a case example of the systemic forces that may contribute to leading an organization away from its principal mission. I explore how what was done was turned into its opposite. That is: “We are protecting psychologists by providing them with ethical guidelines in detention centers with detainees” became the explanatory rubric for a position that violated the association’s stated mission and exposed the organization and individual members to public shame. In addition, I explore how self-silencing becomes a way of adapting to a culture that censures dissent.

Introduction

We didn't know" is the all too common legitimizing trope used to establish distance from disturbing events of a sociopsychological and political nature.  Is such a plea of ignorance consciously or unconsciously motivated lest the speaker be implicated in the acts being opposed?  "We didn't know" typically is invoked when a threat of shame, culpability, or punishment of a sort hangs in the balance.  It may be utilized when social service agencies fail to respond to negligent, abusive, or violent behavior toward those for whom they are responsible for care, or in instances of sexual abuse in military, academic, or religious institutions.  Examples also may be found in the justifications of neighbors of concentration camps during the Second World War, or corporate officers deaf to workers' complaints of malfeasance or corruption within an organization.  It is a widespread self- justificatory response to situations in which the individual might have known, even ought to or could have known what was going on, but for a variety of reasons turned away from knowing.

The article is here.

Wednesday, June 22, 2016

A New Theory Explains How Consciousness Evolved

Michael Graziano
The Atlantic
Originally posted June 6, 2016

Here is an excerpt:

The Attention Schema Theory (AST), developed over the past five years, may be able to answer those questions. The theory suggests that consciousness arises as a solution to one of the most fundamental problems facing any nervous system: Too much information constantly flows in to be fully processed. The brain evolved increasingly sophisticated mechanisms for deeply processing a few select signals at the expense of others, and in the AST, consciousness is the ultimate result of that evolutionary sequence. If the theory is right—and that has yet to be determined—then consciousness evolved gradually over the past half billion years and is present in a range of vertebrate species.

Even before the evolution of a central brain, nervous systems took advantage of a simple computing trick: competition. Neurons act like candidates in an election, each one shouting and trying to suppress its fellows. At any moment only a few neurons win that intense competition, their signals rising up above the noise and impacting the animal’s behavior. This process is called selective signal enhancement, and without it, a nervous system can do almost nothing.

The article is here.

Moral intuitions: Are philosophers experts?

Kevin Tobia, Wesley Buckwalter, and Stephen Stich
Philosophical Psychology, 26(5): 629-638.

Abstract

Recently psychologists and experimental philosophers have reported findings showing that in some cases ordinary people’s moral intuitions are affected by factors of dubious relevance to the truth of the content of the intuition. Some defend the use of intuition as evidence in ethics  by arguing that philosophers are the experts in this area, and philosophers’ moral intuitions are  both different from those of ordinary people and more reliable. We conducted two experiments indicating that philosophers and non-philosophers do indeed sometimes have different moral intuitions, but challenging the notion that philosophers have better or more reliable intuitions.

The article is here.

Tuesday, June 21, 2016

Dignity, Politics, and Medical Assistance in Dying

by Harry Critchley
Impact Ethics
Originally published June 6, 2016

Here is an excerpt:

A common problem with both of these approaches to understanding dignity, however, is the underlying assumption that dignity is best understood from a theoretical perspective. Another, more fruitful approach might be to examine the meaning of dignity with reference to its use in public discourse. On this view, to determine what dignity is requires that we ask what appeals to dignity are intended to do. Dignity is not only, or even primarily, appealed to in the solitude of philosophical contemplation, but rather in the company of others. Regardless of whether we understand dignity as sanctity of life or as autonomy, its emergence and acknowledgement in the political arena is an achievement not wholly dependent on its theoretical grounding.

The article is here.

Keep a List of Unethical Things You’ll Never Do

Mark Chussil
Harvard Business Review
Originally posted May 30, 2016

Here is an excerpt:

In a recent class we talked about less-than-virtu­ous actions we’ve seen in business. Fraudulent ac­counting that wiped out jobs and investors. Efficient operations that inflict misery on food animals. Shortcuts and cover-ups that cost people their lives. It’s easy to create a long list and it’s hard not to be depressed by it.

I asked my students: who, among you, aspires to take such actions? They were appalled, of course. Then I mentioned that the real-life people who actually took those actions were once just like them. They were young; they were eager; they wanted to do fine things. And yet.

The room was very quiet.

The article is here.