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

Tuesday, December 20, 2016

Glitches: A Conversation With Laurie R. Santos

Edge.org
Originally posted November 27, 2016

Here is an excerpt of the article/video:

Scholars like Kahneman, Thaler, and folks who think about the glitches of the human mind have been interested in the kind of animal work that we do, in part because the animal work has this important window into where these glitches come from. We find that capuchin monkeys have the same glitches we've seen in humans. We've seen the standard classic economic biases that Kahneman and Tversky found in humans in capuchin monkeys, things like loss aversion and reference dependence. They have those biases in spades.                                

That tells us something about how those biases work. That tells us those are old biases. They're not built for current economic markets. They're not built for systems dealing with money. There's something fundamental about the way we make sense of choices in the world, and if you're going to attack them and try to override them, you have to do it in a way that's honest about the fact that those biases are going to be way too deep.                                

If you are a Bob Cialdini and you're interested in the extent to which we get messed up by the information we hear that other people are doing, and you learn that it's just us—chimpanzees don't fall prey to that—you learn something interesting about how those biases work. This is something that we have under the hood that's operating off mechanisms that are not old, which we might be able to harness in a very different way than we would have for solving something like loss aversion.                                

What I've found is that when the Kahnemans and the Cialdinis of the world hear about the animal work, both in cases where animals are similar to humans and in cases where animals are different, they get pretty excited. They get excited because it's telling them something, not because they care about capuchins or dogs. They get excited because they care about humans, and the animal work has allowed us to get some insight into how humans tick, particularly when it comes to their biases.

The text/video is here.

The Role of Emotional Intuitions in Moral Judgments and Decisions

Gee, Catherine. 2014.
Journal of Cognition and Neuroethics 2 (1): 161–171.

Abstract

Joshua D. Greene asserts in his 2007 article “The Secret Joke of Kant’s Soul” that consequentialism is the superior moral theory compared to deontology due to its judgments arising from “cognitive” processes alone without (or very little) input from emotive processes. However, I disagree with Greene’s position and instead argue it is the combination of rational and emotive cognitive processes that are the key to forming a moral judgment. Studies on patients who suffered damage to their ventromedial prefrontal cortex will be discussed as they are real-life examples of individuals who, due to brain damage, make moral judgments based predominately on “cognitive” processes. These examples will demonstrate that the results of isolated “cognitive” mental processing are hardly what Greene envisioned. Instead of superior processing and judgments, these individuals show significant impairment. As such, Greene’s account ought to be dismissed for does not stand up to philosophical scrutiny or the psychological literature on this topic.

The article is here.

Monday, December 19, 2016

Normality: Part descriptive, part prescriptive

Adam Bear and Joshua Knobe
Cognition
Published October 24, 2016

Abstract

People’s beliefs about normality play an important role in many aspects of cognition and life (e.g., causal cognition, linguistic semantics, cooperative behavior). But how do people determine what sorts of things are normal in the first place? Past research has studied both people’s representations of statistical norms (e.g., the average) and their representations of prescriptive norms (e.g., the ideal). Four studies suggest that people’s notion of normality incorporates both of these types of norms. In particular, people’s representations of what is normal were found to be influenced both by what they believed to be descriptively average and by what they believed to be prescriptively ideal. This is shown across three domains: people’s use of the word ‘‘normal” (Study 1), their use of gradable adjectives (Study 2), and their judgments of concept prototypicality (Study 3). A final study investigated the learning of normality for a novel category, showing that people actively combine statistical and prescriptive information they have learned into an undifferentiated notion of what is normal (Study 4). Taken together, these findings may help to explain how moral norms impact the acquisition of normality and, conversely, how normality impacts the acquisition of moral norms.

The article is here.

Colorado Voters Approve Aid-In-Dying Measure

John Daley
National Public Radio
Originally published November 10, 2016

Colorado has joined the handful of states that allow terminally ill patients to end their lives with medicine prescribed by a doctor.

Voters passed Proposition 106 by a 65 percent to 35 percent margin.

The fight pitted those who think the terminally ill should have the choice to end their lives if they choose to do so against those who think it's morally wrong and that people might be pressured into ending their lives.

(cut)

Under the Colorado measure, two doctors must agree a terminally ill adult has six months or less to live and is mentally competent. The person would self-administer the drug.

The article is here.

Sunday, December 18, 2016

There may be no worse place for mentally ill people to receive treatment than prison

By The Spotlight Team
The Boston Globe
Originally posted November 25, 2016

Here is an excerpt:

Last year, more than 15,000 prisoners walked out of Massachusetts jails and prisons. More than one-third suffer from mental illness; more than half have a history of addiction. Thousands are coping with both kinds of disorders, their risk of problems amplified as they reenter society.

Within three years of being released, 37 percent of inmates who leave state prisons with mental illnesses are locked up again, compared with 30 percent of those who do not have mental health problems, according to a Department of Correction analysis of 2012 releases. Inmates battling addiction fare worse: About half are convicted of a new crime within three years, according to one state study. And inmates with a “dual diagnosis” of addiction and mental illness, like Nick Lynch, do the worst of all, national studies show.

Despite the vast need — and the potential payoff in reduced recidivism — mental health and substance abuse treatment for many Massachusetts inmates is chronically undermined by clinician shortages, shrinking access to medication, and the widespread use of segregation as discipline. The prison environment itself is a major obstacle to treatment: In a culture ruled by aggression and fear, the trust and openness required for therapy are exponentially harder to achieve.

And when their incarcerations end, many mentally ill and drug-addicted prisoners are sent back into the world without basic tools they need to succeed, such as ready access to medication, addiction counseling, or adequate support and oversight. Such omissions can be critical: The Harvard-led Boston Reentry Study found in 2014 that inmates with a mix of mental illness and addiction are significantly less likely than others to find stable housing, work income, and family support in the critical initial period after leaving prison, leaving them insecure, isolated, and at risk of falling into “diminished mental health, drug use and relapse.”

The article is here.

Saturday, December 17, 2016

Free Will and Autonomous Medical DecisionMaking

Matthew A. Butkus
Neuroethics 3 (1): 75–119.

Abstract

Modern medical ethics makes a series of assumptions about how patients and their care providers make decisions about forgoing treatment. These assumptions are based on a model of thought and cognition that does not reflect actual cognition—it has substituted an ideal moral agent for a practical one. Instead of a purely rational moral agent, current psychology and neuroscience have shown that decision-making reflects a number of different factors that must be considered when conceptualizing autonomy. Multiple classical and contemporary discussions of autonomy and decision-making are considered and synthesized into a model of cognitive autonomy. Four categories of autonomy criteria are proposed to reflect current research in cognitive psychology and common clinical issues.

The article is here.

Friday, December 16, 2016

Why moral companies do immoral things

Michael Skapinker
Financial Times
Originally published November 23, 2016

Here is an excerpt:

But I wondered about the “better than average” research cited above. Could the illusion of moral superiority apply to organisations as well as individuals? And could companies believe they were so superior morally that the occasional lapse into immorality did not matter much? The Royal Holloway researchers said they had recently conducted experiments examining just these issues and were preparing to publish the results. They had found that political groups with a sense of moral superiority felt justified in behaving aggressively towards opponents. In experiments, this meant denying them a monetary benefit.

“It isn’t difficult to imagine a similar scenario arising in a competitive organisational context. To the extent that employees may perceive their organisation to be morally superior to other organisations, they might feel licensed to ‘cut corners’ or behave somewhat unethically — for example, to give their organisation a competitive edge.

“These behaviours may be perceived as justified … or even ethical, insofar as they promote the goals of their morally superior organisation,” they told me.

The article is here.

How a doctor convicted in drugs-for-sex case returned to practice

Danny Robbins
Atlantic Journal Constitution
Part of a series on Physical and Sexual Abuse

Here is an excerpt:

“The pimp with a prescription pad” is what one prosecutor called him during a trial in which it was revealed that more than 400 sexually explicit photos of female patients and other women had been discovered in his office.

In some states, where legislatures have enacted laws prohibiting doctors who commit certain crimes from practicing, Dekle’s career would be over. But in Georgia, where the law gives the medical board the discretion to license anyone it sees fit, he was back in practice two years after leaving prison.

More than a dozen years later, that decision still leads some to wonder what the board was thinking.

“It’s particularly damning that he was using his ability to write prescriptions to further his sexual activities,” said Chris Dorsey, the Georgia Bureau of Investigation agent who led the probe that sent Dekle to prison. “A doctor burglarizes a house and then pays his debt to society, could he be a good doctor? I could argue it both ways. But when you have someone who abused everything centering on a medical practice to victimize all these people, that’s really a separate issue.”

The article is here.

Thursday, December 15, 2016

Informed Consent in Organ Donation and Abandonment of the Dead-Donor Rule

Matthew Phillip Mead
Journal of Cognition and Neuroethics 3 (2): 47–56.

Abstract

There has been considerable discussion regarding the ethics of organ transplantation and the dead-donor rule (DDR). Much of the medical and philosophical literature reveals inherent difficulties in definitions of death and the appropriate time to begin organ procurement. In this essay, an argument is presented for abandoning the DDR and switching to a practice in which donors are informed of the conditions under which their organs will be removed, rather than the current practice of requiring a declaration of death. Informed organ donation consent (IODC) would allow for greater transparency in the organ procurement process and alleviate many of the ethical concerns raised in the literature today surrounding these practices. This has the potential to improve public trust of organ procurement and increase the numbers of donors.

The article is here.