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, October 13, 2016

Richard Swinburne’s Toxic Lecture on Christian Morality

By J. Edward Hackett
Philosophical Percolations
Originally published September 24, 2016

Here is an excerpt:

While Swinburne did not think homosexuality was intrinsically wrong in the same way that adultery was wrong, he argued (if that’s the right verb under some principle of charity) that homosexuality was extrinsically wrong. Homosexuality was a disability in the lacking of the ability to have children, and God’s commands of abstaining from homosexuality might prevent others from fostering this incurable condition in others.

Yeah. I know.

My response was mixture of abhorrence and overwhelming anger, and I tried as I might to encounter this idea calmly. I told him he medicalized being gay in the same way that phrenology medicalized racism. It was obnoxious to listen to Christians lay claim to sacrificial love at this conference, but at the same time not see the virtue of that same love as a possible quality underlying other configurations, yet I told others this is the reason why Christians should read Foucault. When you do, you start to notice how power manifests in local contexts in which those discourses occur.

There was a way power was working in this discourse. Specifically, Foucault exposes how medicalizing discourse divorces the condition apart from the body of the patient. Swinburne advocated “sympathy and not censure” for homosexuals, those with the “incurable condition” and “disability.” In this medical context, medicine acts as a way to dehumanize the person without appearing as if that’s what you’re doing.

The blog post his here.

The influence of intention, outcome and question-wording on children’s and adults’ moral judgments

Gavin Nobes, Georgia Panagiotaki, Kimberley J. Bartholomew
Cognition
Volume 157, December 2016, Pages 190–204

Abstract

The influence of intention and outcome information on moral judgments was investigated by telling children aged 4–8 years and adults (N = 169) stories involving accidental harms (positive intention, negative outcome) or attempted harms (negative intention, positive outcome) from two studies (Helwig, Zelazo, & Wilson, 2001; Zelazo, Helwig, & Lau, 1996). When the original acceptability (wrongness) question was asked, the original findings were closely replicated: children’s and adults’ acceptability judgments were based almost exclusively on outcome, and children’s punishment judgments were also primarily outcome-based. However, when this question was rephrased, 4–5-year-olds’ judgments were approximately equally influenced by intention and outcome, and from 5–6 years they were based considerably more on intention than outcome primarily intention-based. These findings indicate that, for methodological reasons, children’s (and adults’) ability to make intention-based judgment has often been substantially underestimated.

The article is here.

Wednesday, October 12, 2016

Why psychology lost its soul: everything comes from the brain

George Paxinos
The Conversation
Originally published September 22, 2016

Many people today believe they possess a soul. While conceptions of the soul differ, many would describe it as an “invisible force that appears to animate us”.

It’s often believed the soul can survive death and is intimately associated with a person’s memories, passions and values. Some argue the soul has no mass, takes no space and is localised nowhere.

But as a neuroscientist and psychologist, I have no use for the soul. On the contrary, all functions attributable to this kind of soul can be explained by the workings of the brain.

Psychology is the study of behaviour. To carry out their work of modifying behaviour, such as in treating addiction, phobia, anxiety and depression, psychologists do not need to assume people have souls. For the psychologists, it is not so much that souls do not exist, it is that there is no need for them.

It is said psychology lost its soul in the 1930s. By this time, the discipline fully became a science, relying on experimentation and control rather than introspection.

The article is here.

Utilitarian preferences or action preferences? De-confounding action and moral code in sacrificial dilemmas

Damien L. Crone & Simon M. Laham
Personality and Individual Differences, Volume 104, January 2017, Pages 476-481

Abstract

A large literature in moral psychology investigates utilitarian versus deontological moral preferences using sacrificial dilemmas (e.g., the Trolley Problem) in which one can endorse harming one person for the greater good. The validity of sacrificial dilemma responses as indicators of one's preferred moral code is a neglected topic of study. One underexplored cause for concern is that standard sacrificial dilemmas confound the endorsement of specific moral codes with the endorsement of action such that endorsing utilitarianism always requires endorsing action. Two studies show that, after de-confounding these factors, the tendency to endorse action appears about as predictive of sacrificial dilemma responses as one's preference for a particular moral code, suggesting that, as commonly used, sacrificial dilemma responses are poor indicators of moral preferences. Interestingly however, de-confounding action and moral code may provide a more valid means of inferring one's preferred moral code.

The article is here.

Tuesday, October 11, 2016

When fairness matters less than we expect

Gus Cooney, Daniel T. Gilbert, and Timothy D. Wilson
PNAS 2016 ; published ahead of print September 16, 2016

Abstract

Do those who allocate resources know how much fairness will matter to those who receive them? Across seven studies, allocators used either a fair or unfair procedure to determine which of two receivers would receive the most money. Allocators consistently overestimated the impact that the fairness of the allocation procedure would have on the happiness of receivers (studies 1–3). This happened because the differential fairness of allocation procedures is more salient before an allocation is made than it is afterward (studies 4 and 5). Contrary to allocators’ predictions, the average receiver was happier when allocated more money by an unfair procedure than when allocated less money by a fair procedure (studies 6 and 7). These studies suggest that when allocators are unable to overcome their own preallocation perspectives and adopt the receivers’ postallocation perspectives, they may allocate resources in ways that do not maximize the net happiness of receivers.

Significance

Human beings care a great deal about the fairness of the procedures that are used to allocate resources, such as wealth, opportunity, and power. But in a series of experiments, we show that those to whom resources are allocated often care less about fairness than those who allocate the resources expect them to. This “allocator’s illusion” results from the fact that fairness seems more important before an allocation is made (when allocators are choosing a procedure) than afterward (when receivers are reacting to the procedure that allocators chose). This illusion has important consequences for policy-makers, managers, health care providers, judges, teachers, parents, and others who are charged with choosing the procedures by which things of value will be allocated.

The article is here.

How US prisons violate three principles of criminal justice

Judith Lichtenberg
aeon.co
Originally published September 19, 2016

The United States has 5 per cent of the world’s population but 25 per cent of its prisoners. Right now, 2.2 million people are locked up across the country, and while crime has been decreasing since the 1990s, rates of imprisonment are at historic highs. Americans across the political spectrum are deeply dissatisfied with this state of affairs, and agree that mass incarceration costs too much and achieves too little. But there’s also much disagreement – about the role of systemic racism, about the causes of police violence, about the importance of personal responsibility and retribution.

Nevertheless, people can find common ground on three fundamental moral norms that should govern the use of imprisonment as punishment. First, punishments should be proportional to crimes. Second, like cases should be treated alike. Third, criminal punishment should not do more harm than good. Unfortunately, the US system violates each of these principles.

Proportionality requires that the punishment fit the crime. This is more than a mere cliché. It means punishments should be neither excessive nor insufficient. Imprisonment for a parking ticket would be wrong, but so would a slap on the wrist for rape.

Monday, October 10, 2016

Why do suicidal patients wait hours for a hospital bed?

By Corinne Segal
PBS News Hour
September 18, 2016

Here is an excerpt:

Health workers and lawmakers are working to accommodate patients like Durant as America endures a suicide surge, with suicide deaths rising from 29,000 people to 43,000 people between 1999 and 2014. Some have tried to increase the number of psychiatric beds available to suicidal patients, a disappearing resource in recent years that forces patients like Durant to wait longs hours for care. Meanwhile, others are assessing whether the hospital is even the right place to start considering treatment.

In recent decades, “We closed thousands of beds and we didn’t cure mental health,” David Mattodeo, Executive Director of the Massachusetts Association of Behavioral Health Systems, said. “The problem didn’t go away.”

The article is here.

Federal Court Certifies Nationwide Class Action Challenging UBH Coverage Criteria

Press Release
Originally released September 20, 2016

In a significant mental health ruling, the United States District Court for the Northern District of California has come one step closer to ordering health insurance giant United Behavioral Health (UBH) to revamp its medical necessity criteria and reprocess thousands of outpatient, intensive outpatient and residential treatment claims it denied since 2011. Plaintiffs in two companion class-action lawsuits, Wit et al. v. UnitedHealthcare et al. and Alexander et al. v. United Behavioral Health, allege that UBH systematically denies coverage for mental health treatment by developing and applying "medical necessity" criteria that are far more stringent than generally accepted standards of care.

"Yesterday's class certification order is an important victory in the fight for mental health parity," said Meiram Bendat, president of Psych-Appeal, Inc. and co-counsel for the plaintiffs. "It signals that health insurers can be held responsible, on a class-wide basis, for denying insurance coverage for mental health treatment to those desperately in need. Without class certification, few, if any, patients will have the financial or emotional resources necessary to challenge this type of misconduct individually."

The plaintiffs' health plans, governed by the Employee Retirement Income Security Act (ERISA), require UBH to evaluate medical necessity according to generally accepted standards of care. UBH's proprietary medical necessity criteria purport to reflect these standards. However, the plaintiffs allege that a push for profits has led UBH to develop criteria that overemphasize acute mental health and substance use disorder symptoms and disregard chronic or complex conditions that require ongoing care, in contravention of generally accepted standards.

UBH is a subsidiary of UnitedHealth Group and is the country's largest managed behavioral health care organization, serving more than 60 million members.

Psych-Appeal, Inc. and Zuckerman Spaeder LLP have been appointed class counsel by the federal court and also represent plaintiffs in similar cases against Health Care Service Corporation (Blue Cross and Blue Shield of Illinois, Texas, New Mexico, Montana and Oklahoma), Magellan Health Services of California and Blue Shield of California.

The pressor is here.

Sunday, October 9, 2016

Why some people are more altruistic than others

Abigail Marsh
TED Talk
Originally posted June 2016

Why do some people do selfless things, helping other people even at risk to their own well-being? Psychology researcher Abigail Marsh studies the motivations of people who do extremely altruistic acts, like donating a kidney to a complete stranger. Are their brains just different?