Anonymous
kevinmd.com
Originally published January 26, 2017
In the year it has taken for me to finish my medical residency as a junior doctor, two of my colleagues have killed themselves. I’ve read articles that refer to suicide amongst doctors as the profession’s “grubby little secret,” but I’d rather call it exactly how it is: the profession’s shameful and disgusting open secret.
Medical training has long had its culture rooted in ideals of suffering. Not so much for the patients — which is often sadly a given, but for the doctors training inside it. Every generation always looks down on the generation training after it — no one ever had it as hard as them, and thus deserve to suffer just as much, if not more. This dubious school of thought has long been acknowledged as standard practice. To be a good doctor, you must work harder, stay later, know more, and never falter. Weakness in medicine is a failing, and if you admit to struggling, the unspoken opinion (or often spoken) is that you simply couldn’t hack it.
In the cutthroat, often brutalizing culture of medical or surgical training many doctors stay stoically mute in the face of daily, soul destroying adversity; at the worst case, their loudest gesture is deafeningly silent — death by their own hand.
The blog post is here.
Friday, February 17, 2017
Uncertainty Increases the Reliance on Affect in Decisions
Ali Faraji Rad and Michel Tuan Pham
J Consum Res (2017) ucw073.
Published: 23 January 2017
Abstract
How do psychological states of uncertainty influence the way people make decisions? We propose that such states increase the reliance on affective inputs in judgments and decisions. In accord with this proposition, results from six studies show that the priming of uncertainty (vs. certainty) consistently increases the effects of a variety of affective inputs on consumers’ judgments and decisions. Primed uncertainty is shown to amplify the effects of the pleasantness of a musical soundtrack (study 1), the attractiveness of a picture (study 2), the appeal of affective attributes (studies 3 and 4), incidental mood states (study 6), and even incidental states of disgust (study 5). Moreover, both negative and positive uncertainty increase the influence of affect in decisions (study 4). The results additionally show that the increased reliance on affective inputs under uncertainty does not necessarily come at the expense of a reliance on descriptive attribute information (studies 2 and 5), and that the increased reliance on affect under uncertainty is distinct from a general reliance on heuristic or peripheral cues (study 6). The phenomenon may be due to uncertainty threatening the self, thereby encouraging a reliance on inputs that are closer to the self and have high subjective validity.
The article is here.
J Consum Res (2017) ucw073.
Published: 23 January 2017
Abstract
How do psychological states of uncertainty influence the way people make decisions? We propose that such states increase the reliance on affective inputs in judgments and decisions. In accord with this proposition, results from six studies show that the priming of uncertainty (vs. certainty) consistently increases the effects of a variety of affective inputs on consumers’ judgments and decisions. Primed uncertainty is shown to amplify the effects of the pleasantness of a musical soundtrack (study 1), the attractiveness of a picture (study 2), the appeal of affective attributes (studies 3 and 4), incidental mood states (study 6), and even incidental states of disgust (study 5). Moreover, both negative and positive uncertainty increase the influence of affect in decisions (study 4). The results additionally show that the increased reliance on affective inputs under uncertainty does not necessarily come at the expense of a reliance on descriptive attribute information (studies 2 and 5), and that the increased reliance on affect under uncertainty is distinct from a general reliance on heuristic or peripheral cues (study 6). The phenomenon may be due to uncertainty threatening the self, thereby encouraging a reliance on inputs that are closer to the self and have high subjective validity.
The article is here.
Thursday, February 16, 2017
First human-pig 'chimera' created in milestone study
Hannah Devlin
The Guardian
Originally posted January 26, 2017
Scientists have created a human-pig hybrid in a milestone study that raises the prospect of being able to grow human organs inside animals for use in transplants.
It marks the first time that embryos combining two large, distantly-related species have been produced. The creation of this so-called chimera – named after the cross-species beast of Greek mythology – has been hailed as a significant first step towards generating human hearts, livers and kidneys from scratch.
Juan Carlos Izpisua Belmonte, who led the work on the part-pig, part-human embryos at the Salk Institute for Biological Studies in La Jolla, California, said: “The ultimate goal is to grow functional and transplantable tissue or organs, but we are far away from that. This is an important first step.”
The study has reignited ethical concerns that have threatened to overshadow the field’s clinical promise. The work inevitably raises the spectre of intelligent animals with humanised brains and also the potential for bizarre hybrid creatures to be accidentally released into the wild. The US National Institutes of Health (NIH) placed a moratorium on funding for the controversial experiments last year while these risks were considered.
The article is here.
The Guardian
Originally posted January 26, 2017
Scientists have created a human-pig hybrid in a milestone study that raises the prospect of being able to grow human organs inside animals for use in transplants.
It marks the first time that embryos combining two large, distantly-related species have been produced. The creation of this so-called chimera – named after the cross-species beast of Greek mythology – has been hailed as a significant first step towards generating human hearts, livers and kidneys from scratch.
Juan Carlos Izpisua Belmonte, who led the work on the part-pig, part-human embryos at the Salk Institute for Biological Studies in La Jolla, California, said: “The ultimate goal is to grow functional and transplantable tissue or organs, but we are far away from that. This is an important first step.”
The study has reignited ethical concerns that have threatened to overshadow the field’s clinical promise. The work inevitably raises the spectre of intelligent animals with humanised brains and also the potential for bizarre hybrid creatures to be accidentally released into the wild. The US National Institutes of Health (NIH) placed a moratorium on funding for the controversial experiments last year while these risks were considered.
The article is here.
Whatever happened to the DeepMind AI ethics board Google promised?
Alex Hurn
The Guardian
Originally posted January 26, 2017
Three years ago, artificial intelligence research firm DeepMind was acquired by Google for a reported £400m. As part of the acquisition, Google agreed to set up an ethics and safety board to ensure that its AI technology is not abused.
The existence of the ethics board wasn’t confirmed at the time of the acquisition announcement, and the public only became aware of it through a leak to industry news site The Information. But in the years since, senior members of DeepMind have publicly confirmed the board’s existence, arguing that it is one of the ways that the company is trying to “lead the way” on ethical issues in AI.
But in all that time DeepMind has consistently refused to say who is on the board, what it discusses, or publicly confirm whether or not it has even officially met. The Guardian has asked DeepMind and Google multiple times since the acquisition on 26 January 2014 for transparency around the board, and received just one answer on the record.
The article is here.
The Guardian
Originally posted January 26, 2017
Three years ago, artificial intelligence research firm DeepMind was acquired by Google for a reported £400m. As part of the acquisition, Google agreed to set up an ethics and safety board to ensure that its AI technology is not abused.
The existence of the ethics board wasn’t confirmed at the time of the acquisition announcement, and the public only became aware of it through a leak to industry news site The Information. But in the years since, senior members of DeepMind have publicly confirmed the board’s existence, arguing that it is one of the ways that the company is trying to “lead the way” on ethical issues in AI.
But in all that time DeepMind has consistently refused to say who is on the board, what it discusses, or publicly confirm whether or not it has even officially met. The Guardian has asked DeepMind and Google multiple times since the acquisition on 26 January 2014 for transparency around the board, and received just one answer on the record.
The article is here.
Wednesday, February 15, 2017
Recent Trump win on China trademark raises ethics questions
Erika Kinetz
Associated Press
Originally published February 14, 2017
Here is an excerpt:
Ethics lawyers say the trademarks present conflicts of interest for Trump and may violate the emoluments clause of the U.S. Constitution, which bars public servants from accepting anything of value from foreign governments unless explicitly approved by Congress.
Countries could use Trump's desire to control his brand to extend — or withhold — favor, especially a nation such as China where the courts and bureaucracy reflect the imperatives of the ruling Communist Party.
"There can be no question that it is a terrible idea for Donald Trump to be accepting the registration of these valuable property rights from China while he's a sitting president of the United States," said Norman Eisen, who served as chief White House ethics lawyer for President Barack Obama. "It's fair to conclude that this is an effort to influence Mr. Trump that is relatively inexpensive for the Chinese, potentially very valuable to him, but it could be very costly for the United States."
The article is here.
Associated Press
Originally published February 14, 2017
Here is an excerpt:
Ethics lawyers say the trademarks present conflicts of interest for Trump and may violate the emoluments clause of the U.S. Constitution, which bars public servants from accepting anything of value from foreign governments unless explicitly approved by Congress.
Countries could use Trump's desire to control his brand to extend — or withhold — favor, especially a nation such as China where the courts and bureaucracy reflect the imperatives of the ruling Communist Party.
"There can be no question that it is a terrible idea for Donald Trump to be accepting the registration of these valuable property rights from China while he's a sitting president of the United States," said Norman Eisen, who served as chief White House ethics lawyer for President Barack Obama. "It's fair to conclude that this is an effort to influence Mr. Trump that is relatively inexpensive for the Chinese, potentially very valuable to him, but it could be very costly for the United States."
The article is here.
Judge Allows Lawsuit Against Psychologists in C.I.A. Torture Case
Sheri Fink
The New York Times
Originally published January 29, 2017
A federal judge on Friday allowed a case brought by former detainees to move forward against two American psychologists who helped devise the C.I.A.’s now-defunct program to interrogate terrorism suspects using techniques widely considered to be torture.
A United States District Court judge, Justin L. Quackenbush, denied a motion by the psychologists that sought to dismiss the case for lack of jurisdiction under provisions of a 2006 law that limits the ability of detainees to challenge their treatment.
“This ruling sends the strong signal that anyone who participates in shameful and unlawful government torture can’t count on escaping accountability in a court of law,” said Dror Ladin, a staff attorney for the American Civil Liberties Union, which, with the Gibbons law firm in Newark, represents the former detainees.
The article is here.
The New York Times
Originally published January 29, 2017
A federal judge on Friday allowed a case brought by former detainees to move forward against two American psychologists who helped devise the C.I.A.’s now-defunct program to interrogate terrorism suspects using techniques widely considered to be torture.
A United States District Court judge, Justin L. Quackenbush, denied a motion by the psychologists that sought to dismiss the case for lack of jurisdiction under provisions of a 2006 law that limits the ability of detainees to challenge their treatment.
“This ruling sends the strong signal that anyone who participates in shameful and unlawful government torture can’t count on escaping accountability in a court of law,” said Dror Ladin, a staff attorney for the American Civil Liberties Union, which, with the Gibbons law firm in Newark, represents the former detainees.
The article is here.
Tuesday, February 14, 2017
Medical errors: Disclosure styles, interpersonal forgiveness, and outcomes
Hannawa, A. F., Shigemoto, Y., & Little, T. (2016).
Social Science & Medicine, 156, 29-38.
Abstract
Rationale
This study investigates the intrapersonal and interpersonal factors and processes that are associated with patient forgiveness of a provider in the aftermath of a harmful medical error.
Objective
This study aims to examine what antecedents are most predictive of patient forgiveness and non-forgiveness, and the extent to which social-cognitive factors (i.e., fault attributions, empathy, rumination) influence the forgiveness process. Furthermore, the study evaluates the role of different disclosure styles in two different forgiveness models, and measures their respective causal outcomes.
Methods
In January 2011, 318 outpatients at Wake Forest Baptist Medical Center in the United States were randomly assigned to three hypothetical error disclosure vignettes that operationalized verbally effective disclosures with different nonverbal disclosure styles (i.e., high nonverbal involvement, low nonverbal involvement, written disclosure vignette without nonverbal information). All patients responded to the same forgiveness-related self-report measures after having been exposed to one of the vignettes.
Results
The results favored the proximity model of interpersonal forgiveness, which implies that factors more proximal in time to the act of forgiving (i.e., patient rumination and empathy for the offender) are more predictive of forgiveness and non-forgiveness than less proximal factors (e.g., relationship variables and offense-related factors such as the presence or absence of an apology). Patients' fault attributions had no effect on their forgiveness across conditions. The results evidenced sizeable effects of physician nonverbal involvement-patients in the low nonverbal involvement condition perceived the error as more severe, experienced the physician's apology as less sincere, were more likely to blame the physician, felt less empathy, ruminated more about the error, were less likely to forgive and more likely to avoid the physician, reported less closeness, trust, and satisfaction but higher distress, were more likely to change doctors, less compliant, and more likely to seek legal advice.
Conclusion
The findings of this study imply that physician nonverbal involvement during error disclosures stimulates a healing mechanism for patients and the physician-patient relationship. Physicians who disclose a medical error in a nonverbally uninvolved way, on the other hand, carry a higher malpractice risk and are less likely to promote healthy, reconciliatory outcomes.
The article is here.
Social Science & Medicine, 156, 29-38.
Abstract
Rationale
This study investigates the intrapersonal and interpersonal factors and processes that are associated with patient forgiveness of a provider in the aftermath of a harmful medical error.
Objective
This study aims to examine what antecedents are most predictive of patient forgiveness and non-forgiveness, and the extent to which social-cognitive factors (i.e., fault attributions, empathy, rumination) influence the forgiveness process. Furthermore, the study evaluates the role of different disclosure styles in two different forgiveness models, and measures their respective causal outcomes.
Methods
In January 2011, 318 outpatients at Wake Forest Baptist Medical Center in the United States were randomly assigned to three hypothetical error disclosure vignettes that operationalized verbally effective disclosures with different nonverbal disclosure styles (i.e., high nonverbal involvement, low nonverbal involvement, written disclosure vignette without nonverbal information). All patients responded to the same forgiveness-related self-report measures after having been exposed to one of the vignettes.
Results
The results favored the proximity model of interpersonal forgiveness, which implies that factors more proximal in time to the act of forgiving (i.e., patient rumination and empathy for the offender) are more predictive of forgiveness and non-forgiveness than less proximal factors (e.g., relationship variables and offense-related factors such as the presence or absence of an apology). Patients' fault attributions had no effect on their forgiveness across conditions. The results evidenced sizeable effects of physician nonverbal involvement-patients in the low nonverbal involvement condition perceived the error as more severe, experienced the physician's apology as less sincere, were more likely to blame the physician, felt less empathy, ruminated more about the error, were less likely to forgive and more likely to avoid the physician, reported less closeness, trust, and satisfaction but higher distress, were more likely to change doctors, less compliant, and more likely to seek legal advice.
Conclusion
The findings of this study imply that physician nonverbal involvement during error disclosures stimulates a healing mechanism for patients and the physician-patient relationship. Physicians who disclose a medical error in a nonverbally uninvolved way, on the other hand, carry a higher malpractice risk and are less likely to promote healthy, reconciliatory outcomes.
The article is here.
Are Kantians Better Social Partners? People Making Deontological Judgments are Perceived to Be More Prosocial than They Actually are
Capraro, Valerio and Sippel, Jonathan and Zhao, Bonan and others
(January 25, 2017).
Abstract
Why do people make deontological decisions, although they often lead to overall unfavorable outcomes? One account is receiving considerable attention: deontological judgments may signal commitment to prosociality and thus may increase people's chances of being selected as social partners --- which carries obvious long-term benefits. Here we test this framework by experimentally exploring whether people making deontological judgments are expected to be more prosocial than those making consequentialist judgments and whether they are actually so. We use two ways of identifying deontological choices. In a first set of three studies, we use a single moral dilemma whose consequentialist course of action requires a strong violation of Kant's practical imperative that humans should never be used solely as a mere means. In a second set of two studies, we use two moral dilemmas: one whose consequentialist course of action requires no violation of the practical imperative, and one whose consequentialist course of action requires a strong violation of the practical imperative; and we focus on people changing decision when passing from the former dilemma to the latter one, thereby revealing a strong reluctance to violate Kant's imperative. Using economic games, we take three measures of prosociality: trustworthiness, altruism, and cooperation. Our results procure converging evidence for a perception bias according to which people making deontological choices are believed to be more prosocial than those making consequentialist choices, but actually they are not so. Thus, these results provide a piece of evidence against the assumption that deontological judgments signal commitment to prosociality.
The article is here.
(January 25, 2017).
Abstract
Why do people make deontological decisions, although they often lead to overall unfavorable outcomes? One account is receiving considerable attention: deontological judgments may signal commitment to prosociality and thus may increase people's chances of being selected as social partners --- which carries obvious long-term benefits. Here we test this framework by experimentally exploring whether people making deontological judgments are expected to be more prosocial than those making consequentialist judgments and whether they are actually so. We use two ways of identifying deontological choices. In a first set of three studies, we use a single moral dilemma whose consequentialist course of action requires a strong violation of Kant's practical imperative that humans should never be used solely as a mere means. In a second set of two studies, we use two moral dilemmas: one whose consequentialist course of action requires no violation of the practical imperative, and one whose consequentialist course of action requires a strong violation of the practical imperative; and we focus on people changing decision when passing from the former dilemma to the latter one, thereby revealing a strong reluctance to violate Kant's imperative. Using economic games, we take three measures of prosociality: trustworthiness, altruism, and cooperation. Our results procure converging evidence for a perception bias according to which people making deontological choices are believed to be more prosocial than those making consequentialist choices, but actually they are not so. Thus, these results provide a piece of evidence against the assumption that deontological judgments signal commitment to prosociality.
The article is here.
Monday, February 13, 2017
Psychologist recounts interrogation of terror detainee
Shawn Vestal
Spokesman-Review
Originally published January 25, 2017
Here is an excerpt:
Jessen’s account was part of a series of documents recently released as part of a Freedom of Information Act request by the ACLU, which has filed a lawsuit against Jessen and his former business partner, James Mitchell. The interview represents the fullest public description of his role from Jessen, who lives in Spokane and operated a for-profit interrogation firm downtown staffed with former Fairchild Air Force Base officers. He has repeatedly denied interview requests from reporters.
The lawsuit against the two contractors is proceeding through federal court in Spokane. Rahman, through his family, is one of three named plaintiffs.
Jessen was interviewed as part of the CIA investigation into Rahman’s death at a “black site” known as the Salt Pit in Afghanistan in 2002. Rahman was a suspected Afghan militant and the CIA records refer to him as a member of al-Qaida.
In his interview, Jessen said his role varied from observer to hands-on interrogator, but makes clear he was closely involved. Another document says Jessen had six “sessions” with Rahman.
The article is here.
Spokesman-Review
Originally published January 25, 2017
Here is an excerpt:
Jessen’s account was part of a series of documents recently released as part of a Freedom of Information Act request by the ACLU, which has filed a lawsuit against Jessen and his former business partner, James Mitchell. The interview represents the fullest public description of his role from Jessen, who lives in Spokane and operated a for-profit interrogation firm downtown staffed with former Fairchild Air Force Base officers. He has repeatedly denied interview requests from reporters.
The lawsuit against the two contractors is proceeding through federal court in Spokane. Rahman, through his family, is one of three named plaintiffs.
Jessen was interviewed as part of the CIA investigation into Rahman’s death at a “black site” known as the Salt Pit in Afghanistan in 2002. Rahman was a suspected Afghan militant and the CIA records refer to him as a member of al-Qaida.
In his interview, Jessen said his role varied from observer to hands-on interrogator, but makes clear he was closely involved. Another document says Jessen had six “sessions” with Rahman.
The article is here.
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