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

Saturday, February 11, 2017

A Tale of Two Moralities, Part 1

Will Wilkinson
Niskanen Center
Originally posted January 19, 2017

Here is an excerpt:

Because “the establishment” (including the Republican political establishment) is relatively cosmopolitan and liberal (in the broad sense), an outpouring of populist anti-establishment sentiment is going to assume a nationalistic, illiberal form more or less by default. The good news is that anti-elite anybody-but-Hillary-ism doesn’t really imply serious public appetite for anything like alt-right authoritarianism. The bad news is that the liberal-democratic capitalist welfare state and the so-called “neoliberal” global order is far and away the best humanity has ever done, and we’ve taken it for granted. We could very well trash it in a fit of pique, and wind up a middle-income kleptocracy boiling with civil strife and/or destabilize the global order in a way that ends in utter horror.

It is very important to keep this from happening! And that means it’s important to understand the mechanisms underlying our cultural and moral polarization. That’s what I’m going to begin to do in this (long!) post, in a preliminary, speculative, exploratory spirit. I want to push a little deeper than the prevailing journalistic narratives have gone, and churn up some credible empirical hypotheses that I hope will help us eventually home in on the correct diagnosis. Then we can hazard some recommendations that may help reduce polarization and mitigate its bad effects. I’ll do that in a future post.  

This important blog post is here.

Friday, February 10, 2017

Government Ethics Office Website Crashes Under Too Much Traffic — Again

Alina Selyukh
The Two-Way - Breaking News from NPR
Originally posted February 9, 2017

The Office of Government Ethics is back in the news as its website crashed, for the second time in less than a month, again under a flood of inquiries.

The advisory agency typically works to vet people who run the country and detangle them from financial ties that may influence their work in public office. And typically, this work happens quietly in the background when administrations transition from one president to another.

But the OGE has received an extraordinary amount of spotlight as Donald Trump has become president. OGE chief has been one of the loudest critics of Trump's decision to remain the owner of his worldwide business empire, with its vast web of financial interests.

On Thursday, the OGE's website was overwhelmed by a surge of clicks.

"OGE's website, phone system and email system are receiving an extraordinary volume of contacts from citizens about recent events," the agency said on Twitter.

Dysfunction Disorder

Joaquin Sapien
Pro Publica
Originally published on January 17, 2017

Here is an excerpt:

The mental health professionals in both cases had been recruited by Montego Medical Consulting, a for-profit company under contract with New York City's child welfare agency. For more than a decade, Montego was paid hundreds of thousands of dollars a year by the city to produce thousands of evaluations in Family Court cases -- of mothers and fathers, spouses and children. Those evaluations were then shared with judges making decisions of enormous sensitivity and consequence: whether a child could stay at home or if they'd be safer in foster care; whether a parent should be enrolled in a counseling program or put on medication; whether parents should lose custody of their children altogether.

In 2012, a confidential review done at the behest of frustrated lawyers and delivered to the administrative judge of Family Court in New York City concluded that the work of the psychologists lined up by Montego was inadequate in nearly every way. The analysis matched roughly 25 Montego evaluations against 20 criteria from the American Psychological Association and other professional guidelines. None of the Montego reports met all 20 criteria. Some met as few as five. The psychologists used by Montego often didn't actually observe parents interacting with children. They used outdated or inappropriate tools for psychological assessments, including one known as a "projective drawing" exercise.

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Attorneys and psychologists who have worked in Family Court say judges lean heavily on assessments made by psychologists, often referred to as "forensic evaluators." So do judges themselves.

"In many instances, judges rely on forensic evaluators more than perhaps they should," said Jody Adams, who served as a Family Court judge in New York City for nearly 20 years before leaving the bench in 2012. "They should have more confidence in their own insight and judgment. A forensic evaluator's evidence should be a piece of the judge's decision, but not determinative. These are unbelievably difficult decisions; these are not black and white; they are filled with gray areas and they have lifelong consequences for children and their families. So it's human nature to want to look for help where you can get it."

The article is here.

Thursday, February 9, 2017

The Trolley Problem: Video Teaching Tool

The trolley problem explained simply in this video, in case you teach ethics or moral psychology.


The Trolley Problem from Eoin Duffy on Vimeo.

Financial ties between researchers and drug industry linked to positive trial results

British Medical Journal
Press Release
Originally released January 17, 2017

Here is an excerpt:

More than half (58%) of principal investigators had financial ties to the drug industry - including travel expenses, honorariums, payment for advisory work, or stock ownership.

The results show that trials authored by principal investigators with financial ties to drug manufacturers were more likely than other trials to report favourable results.

Even after accounting for factors that may have affected the results, such as funding source and sample size, financial ties were still significantly associated with positive study outcomes.

The authors point to possible mechanisms linking industry funding, financial ties, and trial results such as bias by selective outcome reporting, lack of publication, and inappropriate analyses.

The pressor is here.

Wednesday, February 8, 2017

Medical culture encourages doctors to avoid admitting mistakes

By Lawrence Schlachter
STAT News
Originally published on January 13, 2017

Here are two excerpts:

In reality, the factor that most influences doctors to hide or disclose medical errors should be clear to anyone who has spent much time in the profession: The culture of medicine frowns on admitting mistakes, usually on the pretense of fear of malpractice lawsuits.

But what’s really at risk are doctors’ egos and the preservation of a system that lets physicians avoid accountability by ignoring problems or shifting blame to “the system” or any culprit other than themselves.

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What is a patient to do in this environment? The first thing is to be aware of your own predisposition to take everything your doctor says at face value. Listen closely and you may hear cause for more intense questioning.

You will likely never hear the terms negligence, error, mistake, or injury in a hospital. Instead, these harsh but truthful words and phrases are replaced with softer ones like accident, adverse event, or unfortunate outcome. If you hear any of these euphemisms, ask more questions or seek another opinion from a different doctor, preferably at a different facility.

Most doctors would never tell a flagrant lie. But in my experience as a neurosurgeon and as an attorney, too many of them resort to half-truths and glaring omissions when it comes to errors. Beware of passive language like “the patient experienced bleeding” rather than “I made a bad cut”; attributing an error to random chance or a nameless, faceless system; or trivialization of the consequences of the error by claiming something was “a blessing in disguise.”

The article is here.

The Theory of Cognitive-Ethical-Development Can Solve Any Real-World Problem

Baris Bayram

Abstract

First, it is shown that evidence-based argumentations can demonstrate that anyone's real/ultimate self-interest is compatible with investing in a deliberate development of ethical systems, second, that scientific/causal determinism is not incompatible with ethical transformation efforts, third, that there is a crucial need for a developing a new ethical theory ("cognitive-ethical-developmental and ethical-possibility-enhancement": CED and EPE") that is integration of many scientific theories with a modified version of well-being and welfare ethics in order to effectively address any ethics-related issues for oneself and globally, and how it works. Also, according to this theory, it is primarily argued that both cognitive and ethical development of individuals, and systemic transformations are necessarily needed, and it is demonstrated that how such developments and transformations can be actualized thanks to "CED and EPE" approaches.

The paper is here.

Tuesday, February 7, 2017

Trump's Ethics Plan Is Even Worse Than You Thought

Timothy L. O'Brien
Bloomberg News
Originally posted February 6, 2017

Here is an excerpt:

The documents note that President Trump is to receive “exclusive benefit” from any assets in the trust. In other words, he still could see profits from the Trump Organization flow directly into his wallet and he gets to keep those for himself. While Donald Trump Jr. and Weisselberg have legal authority over the assets in the trust, the president can revoke their authority at any time.

How much money might course through the Trump Organization and find its way to the president may never be discernable because Trump has resisted releasing his tax returns ever since he began his White House bid. Keeping those returns buried is also out of step with presidential tradition. While Trump’s spokeswoman, Kellyanne Conway, has tried to minimize the significance of that lapse, Trump’s refusal to do so continues to concern voters.

Trump’s tax returns are significant -- they would offer the public a necessary window onto his business dealings, his philanthropic efforts, his overseas operations and the financial forces that will come to bear upon him in the White House. Yet Trump has latched on to a number of slender reasons for avoiding releasing them.

The article is here.

Business Leaders Get an ‘F’ in Ethics, Yet Again

Bruce Weinstein
Fortune
Updated: Jan 09, 2016 

Here is an excerpt:

Business ethics can be improved

Public perception is malleable, so there is no reason why business executives have to remain stuck in the bottom of the Gallup poll. I propose the following four strategies for businesses that want to be regarded as honest and trustworthy:

Publicize your values. It never ceases to amaze me how few businesses list their company’s values and ethical commitments on their websites. This is the first Call to Action that I give businesses that hire me as a consultant: put your organization’s mission statement, code of ethics, and core values on the home page where they can be readily accessed.

Hire for character. The values and ethical standards you post on your website don’t mean anything if they’re not embodied by your employees. You understandably devote a lot of energy, time, and resources to hiring people who are knowledgeable and skilled. Isn’t it at least as important to hire people who are consistently honest, accountable, loyal, and fair—that is, men and women of high character?

Fire for character. Just as it’s crucial to bring high-character people into your organization, so too is it to get rid of those who don’t share your organization’s values. No matter how much the senior vice president of marketing knows about his or her field, if he or she has played fast and loose with the truth or hasn’t honored commitments to clients, why keep him or her on the payroll?

Reward excellence. I recently spoke at a Fortune 100 company on the day when five employees who embodied the company’s values were flown in to receive a prestigious award and a handsome bonus. One young man had found a $15,000 diamond ring in his store’s parking lot and had gone to considerable lengths to track down the owner. Imagine how the customer felt when her ring was returned. And imagine the positive word-of-mouth she gave the company.