Melanie A. Homa, Ian H. Stanley, Peter M. Gutierrezb, Thomas E. Joiner
Journal of Affective Disorders
Background
Past research suggests that suicide has a profound impact on surviving family members and friends; yet, little is known about experiences with suicide bereavement among military populations. This study aimed to characterize experiences with suicide exposure and their associations with lifetime and current psychiatric symptoms among military service members and veterans
Methods
A sample of 1,753 United States military service members and veterans completed self-report questionnaires assessing experiences with suicide exposure, lifetime history of suicidal thoughts and behaviors, current suicidal symptoms, and perceived likelihood of making a future suicide attempt
Results
The majority of participants (57.3%) reported knowing someone who had died by suicide, and of these individuals, most (53.1%) reported having lost a friend to suicide. Chi-square tests, one-way ANOVAs, and logistic regression analyses revealed that those who reported knowing a suicide decedent were more likely to report more severe current suicidal symptoms and a history of suicidal thoughts and behaviors compared to those who did not know a suicide decedent. Hierarchical linear regression analyses indicated that greater self-reported interpersonal closeness to a suicide decedent predicted greater self-reported likelihood of a future suicide attempt, even after controlling for current suicidal symptoms and prior suicidal thoughts and behaviors
Limitations
This study utilized cross-sectional data, and information regarding degree of exposure to suicide was not collected
Conclusions
Military personnel and veterans who have been bereaved by suicide may themselves be at elevated risk for suicidal thoughts and behaviors. Additional work is needed to delineate the relationship between these experiences.
The article is here.
Wednesday, October 19, 2016
Moral Responsibility and Mental Illness: A Call for Nuance
Matt King & Joshua May
Draft Paper
Abstract:
Does having a mental illness, in general, affect whether someone is morally responsible for an action? Against this Naive view, we argue for a Nuanced account. Sometimes mental illness absolutely excuses, but other times it doesn't. In some cases, mental illness can actually enhance one’s responsibility. The problem is not just that different theories of responsibility yield different judgments about particular cases. Even in cases when all reasonable theories agree about what's relevant to responsibility, the ways mental illness can affect behavior are so varied that a more nuanced account is warranted.
The paper is here.
Draft Paper
Abstract:
Does having a mental illness, in general, affect whether someone is morally responsible for an action? Against this Naive view, we argue for a Nuanced account. Sometimes mental illness absolutely excuses, but other times it doesn't. In some cases, mental illness can actually enhance one’s responsibility. The problem is not just that different theories of responsibility yield different judgments about particular cases. Even in cases when all reasonable theories agree about what's relevant to responsibility, the ways mental illness can affect behavior are so varied that a more nuanced account is warranted.
The paper is here.
Tuesday, October 18, 2016
The desire to fit in is the root of almost all wrongdoing
Christopher Freiman
Here is an excerpt:
Doing the wrong thing is, for most of us, pretty mundane. It’s not usurping political power or stealing millions of dollars. It’s nervously joining in the chorus of laughs for your co-worker’s bigoted joke or lying about your politics to appease your family at Thanksgiving dinner. We ‘go along to get along’ in defiance of what we really value or believe because we don’t want any trouble. Immanuel Kant calls this sort of excessively deferential attitude servility. Rather than downgrading the values and commitments of others, servility involves downgrading your own values and commitments relative to those of others. The servile person is thus the mirror image of the conventional, self-interested immoralist found in Plato, Hobbes and Hume. Instead of stepping on whomever is in his way to get what he wants, the servile person is, in Kant’s words, someone who ‘makes himself a worm’ and thus ‘cannot complain afterwards if people step on him’.
Kant thinks that your basic moral obligation is to not treat humanity as a mere means. When you make a lying promise that you’ll pay back a loan or threaten someone unless he hands over his wallet, you’re treating your victim as a mere means. You’re using him like a tool that exists only to serve your purposes, not respecting him as a person who has value in himself.
The article is here.
Aeon.co
Originally published in September 30, 2016
Doing the wrong thing is, for most of us, pretty mundane. It’s not usurping political power or stealing millions of dollars. It’s nervously joining in the chorus of laughs for your co-worker’s bigoted joke or lying about your politics to appease your family at Thanksgiving dinner. We ‘go along to get along’ in defiance of what we really value or believe because we don’t want any trouble. Immanuel Kant calls this sort of excessively deferential attitude servility. Rather than downgrading the values and commitments of others, servility involves downgrading your own values and commitments relative to those of others. The servile person is thus the mirror image of the conventional, self-interested immoralist found in Plato, Hobbes and Hume. Instead of stepping on whomever is in his way to get what he wants, the servile person is, in Kant’s words, someone who ‘makes himself a worm’ and thus ‘cannot complain afterwards if people step on him’.
Kant thinks that your basic moral obligation is to not treat humanity as a mere means. When you make a lying promise that you’ll pay back a loan or threaten someone unless he hands over his wallet, you’re treating your victim as a mere means. You’re using him like a tool that exists only to serve your purposes, not respecting him as a person who has value in himself.
The article is here.
Folk Moral Relativism
Hagop Sarkissian, John Park, David Tien, Jennifer Wright & Joshua Knobe
Mind and Language 26 (4):482-505 (2011)
Abstract:
It has often been suggested that people's ordinary understanding of morality involves a belief in objective moral truths and a rejection of moral relativism. The results of six studies call this claim into question. Participants did offer apparently objectivist moral intuitions when considering individuals from their own culture, but they offered increasingly relativist intuitions considering individuals from increasingly different cultures or ways of life. The authors hypothesize that people do not have a fixed commitment to moral objectivism but instead tend to adopt different views depending on the degree to which they consider radically different perspectives on moral questions.
The article is here.
Mind and Language 26 (4):482-505 (2011)
Abstract:
It has often been suggested that people's ordinary understanding of morality involves a belief in objective moral truths and a rejection of moral relativism. The results of six studies call this claim into question. Participants did offer apparently objectivist moral intuitions when considering individuals from their own culture, but they offered increasingly relativist intuitions considering individuals from increasingly different cultures or ways of life. The authors hypothesize that people do not have a fixed commitment to moral objectivism but instead tend to adopt different views depending on the degree to which they consider radically different perspectives on moral questions.
The article is here.
Monday, October 17, 2016
Affective nudging
Eric Schliesser
Digressions and Impressions blog
Originally published September 30, 2016
Here is an excerpt:
Nudging is paternalist. But by making exit easy and avoidance cheap nudges are thought to avoid the worst moral and political problems of paternalism and (other) manipulative practices. (What counts as a significant change of economic incentives is, of course, very contestable, but we leave that aside here.) Nudges may, in fact, sometimes enhance autonomy and freedom, but the way Sunstein & Thaler define 'nudge' one may nudge also for immoral ends. Social engineering does not question the ends.
The modern administrative state is, however, not just a rule-following Weberian bureaucracy where the interaction between state and citizen is governed by the exchange of forms, information, and money. Many civil servants, including ones with very distinct expertise (physicians, psychologists, lawyers, engineers, social service workers, therapists, teachers, correction officers, etc.) enter quite intimately into the lives of lots of citizens. Increasingly (within the context of new public management), government professionals and hired consultants are given broad autonomy to meet certain targets (quotas, budget or volume numbers, etc.) within constrained parameters. (So, for example, a physician is not just a care provider, but also somebody who can control costs.) Bureaucratic management and the political class are agnostic about how the desired outcomes are met, as long as it is legal, efficient and does not generate bad media or adverse political push-back.
The blog post is here.
Digressions and Impressions blog
Originally published September 30, 2016
Here is an excerpt:
Nudging is paternalist. But by making exit easy and avoidance cheap nudges are thought to avoid the worst moral and political problems of paternalism and (other) manipulative practices. (What counts as a significant change of economic incentives is, of course, very contestable, but we leave that aside here.) Nudges may, in fact, sometimes enhance autonomy and freedom, but the way Sunstein & Thaler define 'nudge' one may nudge also for immoral ends. Social engineering does not question the ends.
The modern administrative state is, however, not just a rule-following Weberian bureaucracy where the interaction between state and citizen is governed by the exchange of forms, information, and money. Many civil servants, including ones with very distinct expertise (physicians, psychologists, lawyers, engineers, social service workers, therapists, teachers, correction officers, etc.) enter quite intimately into the lives of lots of citizens. Increasingly (within the context of new public management), government professionals and hired consultants are given broad autonomy to meet certain targets (quotas, budget or volume numbers, etc.) within constrained parameters. (So, for example, a physician is not just a care provider, but also somebody who can control costs.) Bureaucratic management and the political class are agnostic about how the desired outcomes are met, as long as it is legal, efficient and does not generate bad media or adverse political push-back.
The blog post is here.
Do It Well and Do It Right: The Impact of Service Climate and Ethical Climate on Business Performance and theBoundary Conditions
Jiang, K., Hu, J., Hong, Y., Liao, H., & Liu, S.
Journal of Applied Psychology. Advance online publication.
Abstract
Prior research has demonstrated that service climate can enhance unit performance by guiding employees’ service behavior to satisfy customers. Extending this literature, we identified ethical climate toward customers as another indispensable organizational climate in service contexts and examined how and when service climate operates in conjunction with ethical climate to enhance business performance of service units. Based on data collected in 2 phases over 6 months from multiple sources of 196 movie theaters, we found that service climate and ethical climate had disparate impacts on business performance, operationalized as an index of customer attendance rate and operating income per labor hour, by enhancing service behavior and reducing unethical behavior, respectively. Furthermore, we found that service behavior and unethical behavior interacted to affect business performance, in such a way that service behavior was more positively related to business performance when unethical behavior was low than when it was high. This interactive effect between service and unethical behaviors was further strengthened by high market turbulence and competitive intensity. These findings provide new insight into theoretical development of service management and offer practical implications about how to maximize business performance of service units by managing organizational climates and employee behaviors synergistically.
The article is here.
Journal of Applied Psychology. Advance online publication.
Abstract
Prior research has demonstrated that service climate can enhance unit performance by guiding employees’ service behavior to satisfy customers. Extending this literature, we identified ethical climate toward customers as another indispensable organizational climate in service contexts and examined how and when service climate operates in conjunction with ethical climate to enhance business performance of service units. Based on data collected in 2 phases over 6 months from multiple sources of 196 movie theaters, we found that service climate and ethical climate had disparate impacts on business performance, operationalized as an index of customer attendance rate and operating income per labor hour, by enhancing service behavior and reducing unethical behavior, respectively. Furthermore, we found that service behavior and unethical behavior interacted to affect business performance, in such a way that service behavior was more positively related to business performance when unethical behavior was low than when it was high. This interactive effect between service and unethical behaviors was further strengthened by high market turbulence and competitive intensity. These findings provide new insight into theoretical development of service management and offer practical implications about how to maximize business performance of service units by managing organizational climates and employee behaviors synergistically.
The article is here.
Sunday, October 16, 2016
Crossing the Line: Daubert, Dual Roles, and the Admissibility of Forensic Mental Health Testimony
Sara Gordon
Cardozo Law Review, Vol. 37, No. 4, 2016
Abstract:
Psychiatrists and other mental health professionals often testify as forensic experts in civil commitment and criminal competency proceedings. When an individual clinician assumes both a treatment and a forensic role in the context of a single case, however, that clinician forms a dual relationship with the patient — a practice that creates a conflict of interest and violates professional ethical guidelines. The court, the parties, and the patient are all affected by this conflict and the biased testimony that may result from dual relationships. When providing forensic testimony, the mental health professional’s primary duty is to the court, not to the patient, and she has an obligation to give objective and truthful testimony. But this testimony can result in the patient’s detention or punishment, a legal outcome that implicates the mental health professional’s corresponding obligation to “do no harm” to the patient. Moreover, the conflict of interest created by a dual relationship can affect the objectivity and reliability of forensic testimony.
A dual clinical and forensic relationship with a single patient is contrary to quality patient care, and existing clinical and forensic ethical guidelines strongly discourage the practice. Notwithstanding the mental health community’s general consensus about the impropriety of the practice, many courts do not question the mental health professional’s ability to provide forensic testimony for a patient with whom she has a simultaneous clinical relationship. Moreover, some state statutes require or encourage clinicians at state-run facilities to engage in these multiple roles. This Article argues that the inherent conflict created by these dual roles does not provide a reliable basis for forensic mental health testimony under Federal Rule of Evidence 702 and should not be admitted as reliable expert testimony by courts. Because dual relationships are often initiated due to provider shortages and the unavailability of neutral forensic examiners, this Article will also discuss the use of telemedicine as a way to provide forensic evaluations in under served areas, especially those where provider shortages have prompted mental health professionals to engage in dual clinical and forensic roles. Finally, this Article argues that courts should exercise their powers more broadly under Federal Rule of Evidence 706 to appoint neutral and independent mental health experts to conduct forensic evaluations in civil commitment and criminal competency proceedings.
The article is here.
Cardozo Law Review, Vol. 37, No. 4, 2016
Abstract:
Psychiatrists and other mental health professionals often testify as forensic experts in civil commitment and criminal competency proceedings. When an individual clinician assumes both a treatment and a forensic role in the context of a single case, however, that clinician forms a dual relationship with the patient — a practice that creates a conflict of interest and violates professional ethical guidelines. The court, the parties, and the patient are all affected by this conflict and the biased testimony that may result from dual relationships. When providing forensic testimony, the mental health professional’s primary duty is to the court, not to the patient, and she has an obligation to give objective and truthful testimony. But this testimony can result in the patient’s detention or punishment, a legal outcome that implicates the mental health professional’s corresponding obligation to “do no harm” to the patient. Moreover, the conflict of interest created by a dual relationship can affect the objectivity and reliability of forensic testimony.
A dual clinical and forensic relationship with a single patient is contrary to quality patient care, and existing clinical and forensic ethical guidelines strongly discourage the practice. Notwithstanding the mental health community’s general consensus about the impropriety of the practice, many courts do not question the mental health professional’s ability to provide forensic testimony for a patient with whom she has a simultaneous clinical relationship. Moreover, some state statutes require or encourage clinicians at state-run facilities to engage in these multiple roles. This Article argues that the inherent conflict created by these dual roles does not provide a reliable basis for forensic mental health testimony under Federal Rule of Evidence 702 and should not be admitted as reliable expert testimony by courts. Because dual relationships are often initiated due to provider shortages and the unavailability of neutral forensic examiners, this Article will also discuss the use of telemedicine as a way to provide forensic evaluations in under served areas, especially those where provider shortages have prompted mental health professionals to engage in dual clinical and forensic roles. Finally, this Article argues that courts should exercise their powers more broadly under Federal Rule of Evidence 706 to appoint neutral and independent mental health experts to conduct forensic evaluations in civil commitment and criminal competency proceedings.
The article is here.
Saturday, October 15, 2016
Should non-disclosures be considered as morally equivalent to lies within the doctor–patient relationship?
Caitriona L Cox and Zoe Fritz
J Med Ethics 2016;42:632-635
doi:10.1136/medethics-2015-103014
Abstract
In modern practice, doctors who outright lie to their patients are often condemned, yet those who employ non-lying deceptions tend to be judged less critically. Some areas of non-disclosure have recently been challenged: not telling patients about resuscitation decisions; inadequately informing patients about risks of alternative procedures and withholding information about medical errors. Despite this, there remain many areas of clinical practice where non-disclosures of information are accepted, where lies about such information would not be. Using illustrative hypothetical situations, all based on common clinical practice, we explore the extent to which we should consider other deceptive practices in medicine to be morally equivalent to lying. We suggest that there is no significant moral difference between lying to a patient and intentionally withholding relevant information: non-disclosures could be subjected to Bok's ‘Test of Publicity’ to assess permissibility in the same way that lies are. The moral equivalence of lying and relevant non-disclosure is particularly compelling when the agent's motivations, and the consequences of the actions (from the patient's perspectives), are the same. We conclude that it is arbitrary to claim that there is anything inherently worse about lying to a patient to mislead them than intentionally deceiving them using other methods, such as euphemism or non-disclosure. We should question our intuition that non-lying deceptive practices in clinical practice are more permissible and should thus subject non-disclosures to the same scrutiny we afford to lies.
The article is here.
J Med Ethics 2016;42:632-635
doi:10.1136/medethics-2015-103014
Abstract
In modern practice, doctors who outright lie to their patients are often condemned, yet those who employ non-lying deceptions tend to be judged less critically. Some areas of non-disclosure have recently been challenged: not telling patients about resuscitation decisions; inadequately informing patients about risks of alternative procedures and withholding information about medical errors. Despite this, there remain many areas of clinical practice where non-disclosures of information are accepted, where lies about such information would not be. Using illustrative hypothetical situations, all based on common clinical practice, we explore the extent to which we should consider other deceptive practices in medicine to be morally equivalent to lying. We suggest that there is no significant moral difference between lying to a patient and intentionally withholding relevant information: non-disclosures could be subjected to Bok's ‘Test of Publicity’ to assess permissibility in the same way that lies are. The moral equivalence of lying and relevant non-disclosure is particularly compelling when the agent's motivations, and the consequences of the actions (from the patient's perspectives), are the same. We conclude that it is arbitrary to claim that there is anything inherently worse about lying to a patient to mislead them than intentionally deceiving them using other methods, such as euphemism or non-disclosure. We should question our intuition that non-lying deceptive practices in clinical practice are more permissible and should thus subject non-disclosures to the same scrutiny we afford to lies.
The article is here.
Friday, October 14, 2016
First 'three person baby' born using new method
By Michelle Roberts
BBC News online
BBC News online
Originally published September 27, 2016
The world's first baby has been born using a new "three person" fertility technique, New Scientist reveals.
The five-month-old boy has the usual DNA from his mum and dad, plus a tiny bit of genetic code from a donor.
US doctors took the unprecedented step to ensure the baby boy would be free of a genetic condition that his Jordanian mother carries in her genes.
Experts say the move heralds a new era in medicine and could help other families with rare genetic conditions.
But they warn that rigorous checks of this new and controversial technology, called mitochondrial donation, are needed.
It's not the first time scientists have created babies that have DNA from three people - that breakthrough began in the late 1990s - but it is an entirely new and significant method.
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