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

Thursday, August 4, 2016

Undermining Belief in Free Will Diminishes True Self-Knowledge

Elizabeth Seto and Joshua A. Hicks
Disassociating the Agent From the Self
Social Psychological and Personality Science 1948550616653810, first published on June 17, 2016 doi:10.1177/1948550616653810

Undermining the belief in free will influences thoughts and behavior, yet little research has explored its implications for the self and identity. The current studies examined whether lowering free will beliefs reduces perceived true self-knowledge. First, a new free will manipulation was validated. Next, in Study 1, participants were randomly assigned to high belief or low belief in free will conditions and completed measures of true self-knowledge. In Study 2, participants completed the same free will manipulation and a moral decision-making task. We then assessed participants’ perceived sense of authenticity during the task. Results illustrated that attenuating free will beliefs led to less self-knowledge, such that participants reported feeling more alienated from their true selves and experienced lowered perceptions of authenticity while making moral decisions. The interplay between free will and the true self are discussed.

A Unified Code of Ethics for Health Professionals: Insights From an IOM Workshop.

Matthew K. Wynia, Sandeep P. Kishore, & Cynthia D. Belar
JAMA, 2014;311(8):799-800.

Here is an excerpt:

Professional obligations under these social contracts are often expressed in codes of ethics; although, unlike laws and regulations, the level of public engagement in developing professional codes has traditionally been limited. Still, when professional codes have failed to meet societal expectations, they have been publicly criticized and eventually changed, such as when the American Medical Association's code initially failed to fully obligate physicians to care for patients with human immunodeficiency virus infection.

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First, a new social contract should be articulated in a code of ethics that does not focus on the roles and obligations of just 1 subset of health professionals. The traditional approach to professionalism in health care has separated health professionals according to education and credentialing, with each group seeking to establish its own social contract. In negotiating their social roles, this separation has allowed groups at times to ignore, show little regard for, or even be overtly hostile toward the roles of other groups (for example, in debates over scope of practice and payment issues). This approach is counterproductive in today's health care environment, which demands teamwork.

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Second, transdisciplinary professionalism demands more than a 1-time listing of shared values by a multidisciplinary group. A meaningful transdisciplinary professionalism will entail the creation of new institutional frameworks, which are required for 'defining, debating, declaring, distributing and enforcing" the expectations and standards that health care professionals and the public agree should govern work in the health care arena'.

The article is here.

Wednesday, August 3, 2016

Clean eating and dirty burgers: how food became a matter of morals

Julian Baggini
The Guardian
Originally published July 17, 2016

Here is an excerpt:

Perhaps the clearest proof that the way we talk about food is saturated with moralism is the ubiquity of the term “guilt”. Marketing departments have seen the power of this and promoted “guilt-free” snacks and treats. This promises an escape from self-recrimination but simply reinforces it by suggesting that eating the “wrong” kinds of foods does and should make you feel guilty. Hence Madeleine Shaw’s Ready Steady Glow contains a section on “self-love” which includes “forgiveness”, begging the question as to why exactly we need to forgive.

These ways of talking are so embedded in our culture that it is tempting to think they are natural and harmless. But they are neither. The writer Bee Wilson has examined the way we learn to eat from birth. “The moralising language around food encourages us to eat in ways which are both less pleasurable,” she told me, “and also actually less healthy.”

The article is here.

Reason, Emotion, and Implanted Devices

by John D. Lantos
Bioethics.net
Originally published July 13, 2016

Pullman and Hodgkinson present a case that, it seems, should have been an easy one. A competent adult makes a simple request to discontinue a medical therapy. Further, it was a therapy that he’d already tried so personal experience informed his preference to discontinue therapy. His request was repeated over time. He was determined to have adequate decisional capacity. So why did both the physicians and the bioethicists consider this to be a difficult case?

There are certain cases that lead to such dilemmas. They are cases in which emotions tug us in one direction and reason tugs in another. The best example of this type of situation is the difference between withholding a treatment and withdrawing the same treatment. Bioethical principles suggest that these two actions are ethically equivalent. Legal precedent shows that the law treats them as comparable actions. Yet both health professionals and families say that the two actions feel very different. Another example is the difference between withdrawing life-support in a patient who is awake and alert compared to withdrawing life-support in a patient who is unconscious. If the diagnosis and prognosis are the same, then the fact of consciousness does not change the legality or morality of the action. But they feel very different.

The article is here.

Tuesday, August 2, 2016

Competencies for Psychologists in the Domains of Religion and Spirituality

C. Vieten, S. Scammell, A. Pierce, R. Pilato, I Ammondson, K, I. Pargament, & D. Lukoff
Spirituality in Clinical Practice, Vol 3(2), Jun 2016, 92-114.

Abstract

Religion and spirituality are important aspects of human diversity that should receive adequate attention in cultural competence training for psychologists. Furthermore, spiritual and religious beliefs and practices are relevant to psychological and emotional well-being, and clinicians who are trained to sensitively address these domains in their clinical practice should be more effective. Our research team previously published a set of 16 religious and spiritual competencies based on a combination of focus group and survey research with the intent that they could be used to guide training. In the present study, we conducted a survey to determine whether these competencies would be acceptable to a broader population of practicing clinicians. Results indicate a large degree of support for the proposed competencies. Between 73.0 and 94.1% of respondents agreed that psychologists should receive training and demonstrate competence in each of the 16 areas. The majority (52.2%–80.7%) indicated that they had received little or no training, and between 29.7% and 58.6% had received no training at all, in these competencies. We conclude with recommendations for integrating these religious and spiritual competencies more fully into clinical training and practice.

The article is here.

Moral Motivation

Rosati, Connie S.
The Stanford Encyclopedia of Philosophy (Fall 2016 Edition)

In our everyday lives, we confront a host of moral issues. Once we have deliberated and formed judgments about what is right or wrong, good or bad, these judgments tend to have a marked hold on us. Although in the end, we do not always behave as we think we ought, our moral judgments typically motivate us, at least to some degree, to act in accordance with them. When philosophers talk about moral motivation, this is the basic phenomenon that they seek to understand. Moral motivation is an instance of a more general phenomenon—what we might call normative motivation—for our other normative judgments also typically have some motivating force. When we make the normative judgment that something is good for us, or that we have a reason to act in a particular way, or that a specific course of action is the rational course, we also tend to be moved. Many philosophers have regarded the motivating force of normative judgments as the key feature that marks them as normative, thereby distinguishing them from the many other judgments we make. In contrast to our normative judgments, our mathematical and empirical judgments, for example, seem to have no intrinsic connection to motivation and action. The belief that an antibiotic will cure a specific infection may move an individual to take the antibiotic, if she also believes that she has the infection, and if she either desires to be cured or judges that she ought to treat the infection for her own good. All on its own, however, an empirical belief like this one appears to carry with it no particular motivational impact; a person can judge that an antibiotic will most effectively cure a specific infection without being moved one way or another.

The entry is here.

Monday, August 1, 2016

A Review of Research on Moral Injury in Combat Veterans

Sheila Frankfurt and Patricia Frazier
Military Psychology
http://dx.doi.org/10.1037/mil0000132

Abstract


The moral injury construct has been proposed to describe the suffering some veterans experience when they engage in acts during combat that violate their beliefs about their own goodness or the goodness of the world. These experiences are labeled transgressive acts to identify them as potentially traumatic experiences distinct from the fear-based traumas associated with posttraumatic stress disorder. The goal of this article was to review empirical and clinical data relevant to transgressive acts and moral injury, to identify gaps in the literature, and to encourage future research and interventions. We reviewed literature on 3 broad arms of the moral injury model proposed by Litz and colleagues (2009): (a) the definition, prevalence, and potential correlates of transgressive acts (e.g., military training and leadership, combat exposure, and personality), (b) the relations between transgressive acts and the moral injury syndrome (e.g., self-handicapping, self-injury, demoralization), and (c) some of the proposed mechanisms of moral injury genesis (e.g., shame, guilt, social withdrawal, and self-condemnation). We conclude with recommendations for future research for veterans suffering with moral injury.


Combat can require individuals to violate their consciences repeatedly. For several decades, clinicians have noted the psychological impact on veterans of engaging in killing, committing atrocities, and violating the rules of engagement (Haley, 1974). Despite this clinical attention, most psychological research on veterans' war wounds has focused on post traumatic stress disorder (PTSD; American Psychiatric Association, 2013), a fear-based disorder that results from exposure to life-threatening events, rather than on the consequences of active participation in warfare.

The moral injury syndrome was proposed to describe the constellation of shame and guilt based disturbances that some combat veterans experience after engaging in wartime acts of commission (e.g., killing) or omission (e.g., failing to prevent atrocities; Litz et al., 2009). The moral injury syndrome was proposed to be constituted of the PTSD symptoms of intrusive memories, emotional numbing, and avoidance, along with collateral effects such as self-injury, demoralization, and self-handicapping (Litz et al., 2009).

The article is here.

Panel slams plan for human research rules

by David Malakoff
Science  08 Jul 2016:
Vol. 353, Issue 6295, pp. 106-107
DOI: 10.1126/science.353.6295.106

In a surprise development certain to fuel a long-running controversy, a prominent science advisory panel is calling on the U.S. government to abandon a nearly finished update to rules on protecting human research participants. It should wait for a new high-level commission, created by Congress and the president, to recommend improvements and then start over, the panel says.

Policy insiders say the recommendation, made 29 June by a committee of the National Academies of Sciences, Engineering, and Medicine that is examining ways to reduce the regulatory burden on academic scientists, is the political equivalent of a comic book hero trying to step in front of a speeding train in a bid to prevent a wreck.

It's not clear, however, whether the panel will succeed in stopping the regulatory express--or just get run over. Both the Obama administration, which has been pushing to complete the new rules this year, and lawmakers in Congress would need to back the halt--and so far they've been silent.

Still, many researchers and university groups are thrilled with the panel's recommendation, noting that they have repeatedly objected to some of the proposed rule changes as unworkable, but with little apparent impact.

The article is here.

Sunday, July 31, 2016

Neural mechanisms underlying the impact of daylong cognitive work on economic decisions

Bastien Blain, Guillaume Hollard, and Mathias Pessiglione
PNAS 2016 113 (25) 6967-6972

Abstract

The ability to exert self-control is key to social insertion and professional success. An influential literature in psychology has developed the theory that self-control relies on a limited common resource, so that fatigue effects might carry over from one task to the next. However, the biological nature of the putative limited resource and the existence of carry-over effects have been matters of considerable controversy. Here, we targeted the activity of the lateral prefrontal cortex (LPFC) as a common substrate for cognitive control, and we prolonged the time scale of fatigue induction by an order of magnitude. Participants performed executive control tasks known to recruit the LPFC (working memory and task-switching) over more than 6 h (an approximate workday). Fatigue effects were probed regularly by measuring impulsivity in intertemporal choices, i.e., the propensity to favor immediate rewards, which has been found to increase under LPFC inhibition. Behavioral data showed that choice impulsivity increased in a group of participants who performed hard versions of executive tasks but not in control groups who performed easy versions or enjoyed some leisure time. Functional MRI data acquired at the start, middle, and end of the day confirmed that enhancement of choice impulsivity was related to a specific decrease in the activity of an LPFC region (in the left middle frontal gyrus) that was recruited by both executive and choice tasks. Our findings demonstrate a concept of focused neural fatigue that might be naturally induced in real-life situations and have important repercussions on economic decisions.

Significance

In evolved species, resisting the temptation of immediate rewards is a critical ability for the achievement of long-term goals. This self-control ability was found to rely on the lateral prefrontal cortex (LPFC), which also is involved in executive control processes such as working memory or task switching. Here we show that self-control capacity can be altered in healthy humans at the time scale of a workday, by performing difficult executive control tasks. This fatigue effect manifested in choice impulsivity was linked to reduced excitability of the LPFC following its intensive utilization over the day. Our findings might have implications for designing management strategies that would prevent daylong cognitive work from biasing economic decisions.

The research is here.