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

Wednesday, January 25, 2017

The candy diet

Seth Godin
Seth's Blog
Originally posted January 4, 2017

The bestselling novel of 1961 was Allen Drury's Advise and Consent. Millions of people read this 690-page political novel. In 2016, the big sellers were coloring books.

Fifteen years ago, cable channels like TLC (the "L" stood for Learning), Bravo and the History Channel (the "History" stood for History) promised to add texture and information to the blighted TV landscape. Now these networks run shows about marrying people based on how well they kiss.

And of course, newspapers won Pulitzer prizes for telling us things we didn't want to hear. We've responded by not buying newspapers any more.

The decline of thoughtful media has been discussed for a century. This is not new. What is new: A fundamental shift not just in the profit-seeking gatekeepers, but in the culture as a whole.

"Everything should be made as simple as possible, but no simpler."*

[*Ironically, this isn't what Einstein actually said. It was this, "It can scarcely be denied that the supreme goal of all theory is to make the irreducible basic elements as simple and as few as possible without having to surrender the adequate representation of a single datum of experience." Alas, I've been seduced into believing that the shorter one now works better.]

Is it possible we've made things simpler than they ought to be, and established non-curiosity as the new standard?

The blog post is here.

Forgiveness can improve mental and physical health

By Kirsten Weir
The Monitor on Psychology
January 2017, Vol 48, No. 1
Print version: page 30

Here is an excerpt:

One common but mistaken belief is that forgiveness means letting the person who hurt you off the hook. Yet forgiveness is not the same as justice, nor does it require reconciliation, Worthington explains. A former victim of abuse shouldn't reconcile with an abuser who remains potentially dangerous, for example. But the victim can still come to a place of empathy and understanding. "Whether I forgive or don't forgive isn't going to affect whether justice is done," Worthington says. "Forgiveness happens inside my skin."

Another misconception is that forgiving someone is a sign of weakness. "To that I say, well, the person must not have tried it," says Worthington.

And there may be very good reasons to make the effort. Research has shown that forgiveness is linked to mental health outcomes such as reduced anxiety, depression and major psychiatric disorders, as well as with fewer physical health symptoms and lower mortality rates. In fact, researchers have amassed enough evidence of the benefits of forgiveness to fill a book; Toussaint, Worthington and David R. Williams, PhD, edited a 2015 book, "Forgiveness and Health," that detailed the physical and psychological benefits.

Toussaint and Worthington suggest that stress relief is probably the chief factor connecting forgiveness and well-being. "We know chronic stress is bad for our health," Toussaint says. "Forgiveness allows you to let go of the chronic interpersonal stressors that cause us undue burden."

While stress relief is important, Enright believes there are other important mechanisms by which forgiveness works its magic. One of those, he suggests, is "toxic" anger. "There's nothing wrong with healthy anger, but when anger is very deep and long lasting, it can do a number on us systemically," he says. "When you get rid of anger, your muscles relax, you're less anxious, you have more energy, your immune system can strengthen."

The article is here.

Tuesday, January 24, 2017

Explanatory Judgment, Moral Offense and Value-Free Science

Matteo Colombo
Imperfect Cognitions
Originally posted September 27, 2016

Here is the conclusion:

Our findings indicate that people’s judgements about scientific results are often imbued with moral value. While this conclusion suggests that, as a matter of psychological fact, the ideal of a value-free science may not be achievable, it raises important questions about the attainment of scientific knowledge in democratic societies. How can scientific evidence be more effectively conveyed to the public? What is it that drives public controversy over such issues as climate change, vaccinations and genetically modified organisms? Does the prevalent political and moral homogeneity in many present-day scientific communities hinder or systematically bias their pursuit of knowledge?

The blog post is here.

Editor's Note: Value-free or objective psychotherapy is a myth. We always brings our morals and values into the psychotherapy relationship.

Dissed by Unhappy Patients? Here's What to Do

by Roger Sergel
Senior Executive Editor
MedPage Today Video
Originally posted January 04, 2017



Monday, January 23, 2017

Harvard psychologist says people judge you based on 2 criteria when they first meet you

Jenna Goudreau
Business Insider
Originally published January 16, 2016

Here is an excerpt:

Psychologists refer to these dimensions as warmth and competence, respectively, and ideally you want to be perceived as having both.

Interestingly, Cuddy says that most people, especially in a professional context, believe that competence is the more important factor. After all, they want to prove that they are smart and talented enough to handle your business.

But in fact, warmth, or trustworthiness, is the most important factor in how people evaluate you.

"From an evolutionary perspective," Cuddy says, "it is more crucial to our survival to know whether a person deserves our trust."

It makes sense when you consider that in cavemen days it was more important to figure out if your fellow man was going to kill you and steal all your possessions than if he was competent enough to build a good fire.

But while competence is highly valued, Cuddy says that it is evaluated only after trust is established. And focusing too much on displaying your strength can backfire.

The article is here.

Selling conscience short: a response to Schuklenk and Smalling on conscientious objections by medical professionals

Jocelyn Maclure & Isabelle Dumont
J Med Ethics doi:10.1136/medethics-2016-103903

Abstract

In a thought-provoking paper, Schuklenk and Smalling argue that no right to conscientious objection should be granted to medical professionals. First, they hold that it is impossible to assess either the truth of conscience-based claims or the sincerity of the objectors. Second, even a fettered right to conscientious refusal inevitably has adverse effects on the rights of patients. We argue that the main problem with their position is that it is not derived from a broader reflection on the meaning and implications of freedom of conscience and reasonable accommodation. We point out that they collapse two related but distinct questions, that is, the subjective conception of freedom of conscience and the sincerity test. We note that they do not successfully show that the standard norm according to which exemption claims should not impose undue hardship on others is unworkable. We suggest that the main reason why arguments such as no one is forced to be a medical professional are flawed is that public norms should not constrain citizens to choose between two of their basic rights unless it is necessary. In fine, Schuklenk and Smalling, who see conscience claims as arbitrary dislikes, sell freedom of conscience short and forego any attempts at balancing the competing rights involved. We maintain the authors neglect that most of legal reasoning is contextual and that the blanket restriction of healthcare professionals' freedom of conscience is disproportionate.

The article is here.

Sunday, January 22, 2017

State Supreme Court Ruling Expands 'Tarasoff' Duty for Washington State Clinicians

Psychiatric News Alert
Originally released January 3, 2017

A Washington state Supreme Court decision appears to significantly broaden the duty that psychiatrists and other mental health professionals in that state have to protect and warn potential victims of violence by a patient under their care.

In Volk v. De Meerleer, the Washington state Supreme Court expanded the so-called Tarasoff standard regarding a mental health professional's duty to protect and warn a third party of possible violence, asserting that the duty extends to any possible victim--even one that has not been specifically identified by the patient.

The ruling applies only to clinicians in Washington state. Although other states could conceivably adopt a similar standard, the ruling does not establish a legal precedent outside of Washington. (It was a 1976 case, Tarasoff v. Regents of the University of California, that established the principle that a mental health professional has the duty to protect a third party, specifically identified by a patient, that he or she may be potential victim of violence.)

Tarasoff has typically been interpreted to mean that the mental health provider owes a duty to the intended victim if the victim is identified or reasonably identifiable. But the new decision by the Washington state Supreme Court suggests that the duty is more expansive and that the provider may have an obligation to probe statements about violence to determine whether there is an intended victim and/or to infer intended victims from past sessions.

The decision creates a new category of "medical negligence," rendering clinicians in Washington state potentially legally liable if it is determined that they should have known someone would be a victim of violence. APA signed on to an amicus brief with the Washington State Medical Society and six other groups saying that a lower court's finding that mental health professionals owe a duty of care to the general public, not just to reasonably identifiable third parties, places an unfair burden on clinicians.

APA CEO and Medical Director Saul Levin, M.D., M.P.A., said the ruling is a troubling one. "The court's ruling in Volk v. De Meerleer places clinicians in Washington state in a difficult position and could have detrimental effects on the patient-psychiatrist relationship," he said. "To the extent that a similar standard of liability could be adopted in other states, it should be of concern to psychiatrists and mental health professionals everywhere. APA will continue to follow developments in Washington state and continue to advocate for a fair and rational approach to Tarasoff duties."

APA President Maria A. Oquendo, M.D., Ph.D., echoed those remarks. "Holding mental health professionals liable to third-party victims who were not  identifiable as targets of actual threats places an unreasonable burden on mental health professionals," she said. "This decision marks a significant departure from previous case law concerning Tarasoff duties. Leaving it to a jury to determine whether a mental health provider 'should have known' that a patient would be dangerous has a real potential to interfere with treatment of mental health patients."

Marvin Swartz, M.D., chair of the APA Committee on Judicial Action, told Psychiatric News that the decision potentially undermines the traditional understanding of physician liability. "Expanding physician liability to a new doctrine of 'medical negligence' suggests that courts and juries might begin to adopt a liability standard akin to strict product liability rather than the established standards of medical malpractice," he said. "The likely result would be a serious undermining of the physician/patient relationship."

Saturday, January 21, 2017

Elevation: A review of scholarship on a moral and other-praising emotion

Andrew L. Thomson and Jason T. Siegel
The Journal Of Positive Psychology 

Abstract

The term elevation (also referred to as moral elevation), described by Thomas Jefferson and later coined by Jonathan Haidt, refers to the suite of feelings people may experience when witnessing an instance of moral beauty. The construct of elevation signifies the emotion felt when a person is a witness to, but not a recipient of, the moral behavior of others. Scholarship examining elevation has burgeoned since Haidt first introduced the construct. Researchers have explored the antecedents of, and outcomes associated with, witnessing instances of moral beauty. The current review will outline the existing scholarship on elevation, highlight conflicting findings, point out critical gaps in the current state of elevation research, and delineate fertile future directions for basic and applied research. Continued investigation of the affective, motivational, and behavioral responses associated with witnessing virtuous actions of others is warranted.

The research is here.

Friday, January 20, 2017

Why is everyone talking about algorithms?

Discover Society
Originally published January 3, 2017

Here is an excerpt:

The notion of the algorithm though, is also becoming really quite powerful in its own right. The very notion of the algorithm has taken on a life of its own, especially in the popular media. Algorithms are becoming the shadowy figures that in some way embody our wider fears and concerns. The visions we have of algorithms chime with broader feelings of a loss of control, of accelerated lives that are speeding away from us, of our inability to cope with the unmanageable information that we are exposed to, or the feeling that our lives are governed for us and that we have less discretion, autonomy or voice.

The talk about algorithms is a product of the powerful role of algorithms in our lives, but the talk around algorithms also seems to tap into broader concerns about powerlessness and the limitations placed on our discretion and choice. The algorithm is coming to embody the sense of life as out of our control. Algorithms are evoked to speak to these fears and concerns. This is not to say that they don’t have material influences on our lives, they clearly have powerful consequences. But the idea of the algorithm is also now a powerful presence, jumping out suddenly from the mass of code within which everyday life is lived to give us the occasional fright or to remind us of our sense of limited autonomy.

The article is here.