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

Thursday, February 23, 2017

Equipoise in Research: Integrating Ethics and Science in Human Research

Alex John London
JAMA. 2017;317(5):525-526. doi:10.1001/jama.2017.0016

The principle of equipoise states that, when there is uncertainty or conflicting expert opinion about the relative merits of diagnostic, prevention, or treatment options, allocating interventions to individuals in a manner that allows the generation of new knowledge (eg, randomization) is ethically permissible. The principle of equipoise reconciles 2 potentially conflicting ethical imperatives: to ensure that research involving human participants generates scientifically sound and clinically relevant information while demonstrating proper respect and concern for the rights and interests of study participants.

The article is here.

How To Spot A Fake Science News Story

Alex Berezow
American Council on Science and Health
Originally published January 31, 2017

Here is an excerpt:

How to Detect a Fake Science News Story

Often, I have been asked, "How can you tell if a science story isn't legitimate?" Here are some red flags:

1) The article is very similar to the press release on which it was based. This indicates whether the article is science journalism or just public relations.

2) The article makes no attempt to explain methodology or avoids using any technical terminology. (This indicates the author may be incapable of understanding the original paper.)

3) The article does not indicate any limitations on the conclusions of the research. (For example, a study conducted entirely in mice cannot be used to draw firm conclusions about humans.)

4) The article treats established scientific facts and fringe ideas on equal terms.

5) The article is sensationalized; i.e., it draws huge, sweeping conclusions from a single study. (This is particularly common in stories on scary chemicals and miracle vegetables.)

6) The article fails to separate scientific evidence from science policy. Reasonable people should be able to agree on the former while debating the latter. (This arises from the fact that people ascribe to different values and priorities.)

The article is here.

Wednesday, February 22, 2017

It's time for some messy, democratic discussions about the future of AI

Jack Stilgoe and Andrew Maynard
The Guardian
Originally posted February 1, 2017

Here is an excerpt:

The principles that came out of the meeting are, at least at first glance, a comforting affirmation that AI should be ‘for the people’, and not to be developed in ways that could cause harm. They promote the idea of beneficial and secure AI, development for the common good, and the importance of upholding human values and shared prosperity.

This is good stuff. But it’s all rather Motherhood and Apple Pie: comforting and hard to argue against, but lacking substance. The principles are short on accountability, and there are notable absences, including the need to engage with a broader set of stakeholders and the public. At the early stages of developing new technologies, public concerns are often seen as an inconvenience. In a world in which populism appears to be trampling expertise into the dirt, it is easy to understand why scientists may be defensive.

But avoiding awkward public conversations helps nobody. Scientists are more inclined to guess at what the public are worried about than to ask them, which can lead to some serious blind spots – not necessarily in scientific understanding (although this too can occur), but in the direction and nature of research and development.

The article is here.

Moralized Rationality: Relying on Logic and Evidence in the Formation and Evaluation of Belief Can Be Seen as a Moral Issue

Ståhl T, Zaal MP, Skitka LJ (2016)
PLoS ONE 11(11): e0166332. doi:10.1371/journal.pone.0166332

Abstract

In the present article we demonstrate stable individual differences in the extent to which a reliance on logic and evidence in the formation and evaluation of beliefs is perceived as a moral virtue, and a reliance on less rational processes is perceived as a vice. We refer to this individual difference variable as moralized rationality. Eight studies are reported in which an instrument to measure individual differences in moralized rationality is validated. Results show that the Moralized Rationality Scale (MRS) is internally consistent, and captures something distinct from the personal importance people attach to being rational (Studies 1–3). Furthermore, the MRS has high test-retest reliability (Study 4), is conceptually distinct from frequently used measures of individual differences in moral values, and it is negatively related to common beliefs that are not supported by scientific evidence (Study 5). We further demonstrate that the MRS predicts morally laden reactions, such as a desire for punishment, of people who rely on irrational (vs. rational) ways of forming and evaluating beliefs (Studies 6 and 7). Finally, we show that the MRS uniquely predicts motivation to contribute to a charity that works to prevent the spread of irrational beliefs (Study 8). We conclude that (1) there are stable individual differences in the extent to which people moralize a reliance on rationality in the formation and evaluation of beliefs, (2) that these individual differences do not reduce to the personal importance attached to rationality, and (3) that individual differences in moralized rationality have important motivational and interpersonal consequences.

The article is here.

Tuesday, February 21, 2017

Pre-existing Conditions and Medical Underwriting in the Individual Insurance Market Prior to the ACA

Gary Claxton, Cynthia Cox,  Anthony Damico, Larry Levitt, and Karen Pollitz
Kaiser Family Foundation
Originally posted December 16, 2016

Here is an excerpt:

Estimates of the Share of Adults with Pre-Existing Conditions

We estimate that 27% of adult Americans under the age of 65 have health conditions that would likely leave them uninsurable if they applied for individual market coverage under pre-ACA underwriting practices that existed in nearly all states. While a large share of this group has coverage through an employer or public coverage where they do not face medical underwriting, these estimates quantify how many people could be ineligible for individual market insurance under pre-ACA practices if they were to ever lose this coverage. This is a conservative estimate as these surveys do not include sufficient detail on several conditions that would have been declinable before the ACA (such as HIV/AIDS, or hepatitis C).  Additionally, millions more have other conditions that could be either declinable by some insurers based on their pre-ACA underwriting guidelines or grounds for higher premiums, exclusions, or limitations under pre-ACA underwriting practices. In a separate Kaiser Family Foundation poll, most people (53%) report that they or someone in their household has a pre-existing condition.

The article is here.

Let's not be friends: A risk of Facebook

By Amy Novotney
The Monitor on Psychology
2017, Vol 48, No. 2
Print version: page 18

Here is an excerpt:

Talking to clients about their privacy concerns.

Kolmes advises all clinicians to discuss privacy risks involved in using social media with their clients and to work through how to handle a situation in which a therapist's name pops up under their "People You May Know" tab.

"It's about having clear and open conversations with your clients about what you're going to do to protect their privacy and confidentiality and avoid inviting a multiple relationship, and letting them know they can also discuss this with the therapist if it comes up on their end," Kolmes says. When she does receive a friend request from a client on Facebook, she waits until she sees him or her next in session and checks to see if the request was accidental or not. Regardless of whether they searched for her or just had her recommended as a friend, she reminds them about the importance of patient confidentiality and privacy, and notes that following one another on social media can add a "social" element to their work and can complicate matters when it comes to what the therapist is supposed to know or not know about them.

The article is here.

Monday, February 20, 2017

Getting Emotions Right in Moral Psychology

Piercarlo Valdesolo

Abstract:

The past two decades of research has repeatedly identified the importance of emotion to moral
judgment, but moral psychology continues to be in need of more nuanced and developed theories
of emotion to inform its process models. Closer attention to how modern affective science has
divided the landscape of emotions can not only help more accurately map the moral domain, but
also help solve current theoretical debates.

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Basic Emotions and Moral Foundations

MFT argues for the existence of moral foundations comprised of innate cognitive
mechanisms that are responsive to a set of particular adaptive concerns relevant to social living
(e.g. protecting children, forming coalitions). These mechanisms are triggered by particular social
cues (e.g. distress, cheating, uncleanliness), and in turn trigger psychological responses, including
characteristic emotional states, geared towards motivating adaptive behavioral responses. In
keeping with BET, these characteristic emotions represent distinct biological mechanisms thought
to “prompt us in a direction that, in the course of our evolution, has done better than other
solutions in recurring circumstances” (Ekman & Cordaro, 2011, p.364).

Critics of whole number approaches to morality, however, have argued that it is precisely
this conceptual reliance on BET that is problematic (Cameron et al 2013; Schein & Gray; Gray &
Keeney 2015a; Gray, Young and Waytz 2012; Cheng?). These researchers argue that in adopting
this theory of emotions, any theory of distinct moral domains rests on an empirically untenable
basis. Specifically, given that there is no good evidence showing that discrete emotions reflect
“affect programs”, or any other kind of consistent and coordinated affective response specific to
particular kinds of adaptive challenges, then there will likely be no solid empirical basis to accept
the existence of consistent and coordinated psychological responses to discrete moral concerns.

The paper is here.

The Elements of Guile - Harper's Magazine


Sunday, February 19, 2017

Most People Consider Themselves to Be Morally Superior

By Cindi May
Scientific American
Originally published on January 31, 2017

Here are two excerpts:

This self-enhancement effect is most profound for moral characteristics. While we generally cast ourselves in a positive light relative to our peers, above all else we believe that we are more just, more trustworthy, more moral than others. This self-righteousness can be destructive because it reduces our willingness to cooperate or compromise, creates distance between ourselves and others, and can lead to intolerance or even violence. Feelings of moral superiority may play a role in political discord, social conflict, and even terrorism.

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So we believe ourselves to be more moral than others, and we make these judgments irrationally. What are the consequences? On the plus side, feelings of moral superiority could, in theory, protect our well-being. For example, there is danger in mistakenly believing that people are more trustworthy or loyal than they really are, and approaching others with moral skepticism may reduce the likelihood that we fall prey to a liar or a cheat. On the other hand, self-enhanced moral superiority could erode our own ethical behavior. Evidence from related studies suggests that self-perceptions of morality may “license” future immoral actions.

The article is here.