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, June 14, 2017

Should We Outsource Our Moral Beliefs to Others?

Grace Boey
3 Quarks Daily
Originally posted May 29, 2017

Here is an excerpt:

Setting aside the worries above, there is one last matter that many philosophers take to be the most compelling candidate for the oddity of outsourcing our moral beliefs to others. As moral agents, we’re interested in more than just accumulating as many true moral beliefs as possible, such as ‘abortion is permissible’, or ‘killing animals for sport is wrong’. We also value things such as developing moral understanding, cultivating virtuous characters, having appropriate emotional reactions, and the like. Although moral deference might allow us to acquire bare moral knowledge from others, it doesn’t allow us to reflect or cultivate these other moral goods which are central to our moral identity.

Consider the value we place on understanding why we think our moral beliefs are true. Alison Hills notes that pure moral deference can’t get us to such moral understanding. When Bob defers unquestioningly to Sally’s judgment that abortion is morally permissible, he lacks an understanding of why this might be true. Amongst other things, this prevents Bob from being able to articulate, in his own words, the reasons behind this claim. This seems strange enough in itself, and Hills argues for at least two reasons why Bob’s situation is a bad one. For one, Bob’s lack of moral understanding prevents him from acting in a morally worthy way. Bob wouldn’t deserve any moral praise for, say, shutting down someone who harasses women who undergo the procedure.

Moreover, Bob’s lack of moral understanding seems to reflect a lack of good moral character, or virtue. Bob’s belief that ‘late-term abortion is permissible’ isn’t integrated with the rest of his thoughts, motivations, emotions, and decisions. Moral understanding, of course, isn’t all that matters for virtue and character. But philosophers who disagree with Hills on this point, like Robert Howell and Errol Lord, also note that moral deference reflects a lack of virtue and character in other ways, and can prevent the cultivation of these traits.

The article is here.

Tuesday, June 13, 2017

Why It’s So Hard to Admit You’re Wrong

Kristin Wong
The New York Times
Originally published May 22, 2017

Here are two excerpts:

Mistakes can be hard to digest, so sometimes we double down rather than face them. Our confirmation bias kicks in, causing us to seek out evidence to prove what we already believe. The car you cut off has a small dent in its bumper, which obviously means that it is the other driver’s fault.

Psychologists call this cognitive dissonance — the stress we experience when we hold two contradictory thoughts, beliefs, opinions or attitudes.

(cut)

“Cognitive dissonance is what we feel when the self-concept — I’m smart, I’m kind, I’m convinced this belief is true — is threatened by evidence that we did something that wasn’t smart, that we did something that hurt another person, that the belief isn’t true,” said Carol Tavris, a co-author of the book “Mistakes Were Made (But Not by Me).”

She added that cognitive dissonance threatened our sense of self.

“To reduce dissonance, we have to modify the self-concept or accept the evidence,” Ms. Tavris said. “Guess which route people prefer?”

Or maybe you cope by justifying your mistake. The psychologist Leon Festinger suggested the theory of cognitive dissonance in the 1950s when he studied a small religious group that believed a flying saucer would rescue its members from an apocalypse on Dec. 20, 1954. Publishing his findings in the book “When Prophecy Fails,” he wrote that the group doubled down on its belief and said God had simply decided to spare the members, coping with their own cognitive dissonance by clinging to a justification.

“Dissonance is uncomfortable and we are motivated to reduce it,” Ms. Tavris said.

When we apologize for being wrong, we have to accept this dissonance, and that is unpleasant. On the other hand, research has shown that it can feel good to stick to our guns.

Psychiatry’s “Goldwater Rule” has never met a test like Donald Trump

Brian Resnick
Vox.com
Originally published May 25, 2017

Here is an excerpt:

Some psychiatrists are saying it’s time to rethink this core ethical guideline. The rule, they say, is acting like a gag order, preventing qualified psychiatrists from giving the public important perspective on the mental health of a president whose behavior is out of step with any other president in history.

“The public has a right to medical and psychiatric knowledge about its leaders — at least in a democracy,” Nassir Ghaemi, a Tufts University psychiatrist, recently argued at an APA conference. “Why can’t we have a reasoned scientific discussion on this matter? Why do we just have complete censorship?”

The controversy is sure to rage on, as many psychiatrists stand by the professional precedent. The rule itself has even been expanded recently. But just the existence of the debate is an incredible moment not only in the field of psychiatry but in American politics. It’s not just armchair psychiatrists who are concerned about Trump’s mental health — some of the real ones are even willing to rethink their professional ethics because of it.

The article is here.

Monday, June 12, 2017

New bill requires annual ethics training for lawmakers

Pete Kasperowicz
The Washington Examiner
Originally posted May 26, 2017

Members of the House would have to undergo mandated annual ethics training under a new bill offered by Reps. David Cicilline, D-R.I., and Dave Trott, R-Mich.

The two lawmakers said senators are already taking "ongoing" ethics classes, and House staffers are required to undergo training each year. But House lawmakers themselves are exempt.

"Elected officials should always be held to the highest standards of conduct," Cicilline said Thursday. "That's why it's absurd that members of the U.S. House do not have to complete annual ethics training. We need to close this loophole now."

Trott said his constituents believe lawmakers are above the law, and said his bill would help address that complaint.

"No one is above the law, and members of Congress must live by the laws they create," he said.

The article is here.

Views of US Moral Values Slip to Seven-Year Lows

Gallup
Originally posted May 22, 2017

Americans' ratings of U.S. moral values, consistently negative through the years, have slipped to their lowest point in seven years. More than four in five (81%) now rate the state of moral values in the U.S. as only fair or poor.

Since Gallup first asked in 2002 whether the nation's moral values were getting better or getting worse, the percentage saying worse has always been well above the majority level, ranging from a low of 64% in November 2004 to a high of 82% in May 2007. Over the past six years, it has stayed within a five-point range, reaching a low of 72% in 2013 and 2015 before climbing to this year's high of 77%.

Gallup's question about the current state of moral values getting better or worse has been asked over the same 16-year span as the question about the overall state of moral values. The combined percentage saying moral values are only fair or poor through the years has generally aligned with views about moral values getting worse.

The article is here.

Sunday, June 11, 2017

Beyond Googling: The Ethics of Using Patients' Electronic Footprints in Psychiatric Practice

Carl Fisher and Paul Appelbaum
Harvard Review of Psychiatry

Abstract

Electronic communications are an increasingly important part of people's lives, and much information is accessible through such means. Anecdotal clinical reports indicate that mental health professionals are beginning to use information from their patients' electronic activities in treatment and that their data-gathering practices have gone far beyond simply searching for patients online. Both academic and private sector researchers are developing mental health applications to collect patient information for clinical purposes. Professional societies and commentators have provided minimal guidance, however, about best practices for obtaining or using information from electronic communications or other online activities. This article reviews the clinical and ethical issues regarding use of patients' electronic activities, primarily focusing on situations in which patients share information with clinicians voluntarily. We discuss the potential uses of mental health patients' electronic footprints for therapeutic purposes, and consider both the potential benefits and the drawbacks and risks. Whether clinicians decide to use such information in treating any particular patient-and if so, the nature and scope of its use-requires case-by-case analysis. But it is reasonable to assume that clinicians, depending on their circumstances and goals, will encounter circumstances in which patients' electronic activities will be relevant to, and useful in, treatment.

The article is here.

Saturday, June 10, 2017

Feds probing psychiatric hospitals for locking in patients to boost profits

Beth Mole
Ars Technica
Originally published May 24, 2017

At least three US federal agencies are now investigating Universal Health Services over allegations that its psychiatric hospitals keep patients longer than needed in order to milk insurance companies, Buzzfeed News reports.

According to several sources, the UHS' chain of psychiatric facilities—the largest in the country—will delay patients' discharge dates until the day insurance coverage runs out, regardless of the need of the patient. Because the hospitals are reimbursed per day, the practice extracts the maximum amount of money from insurance companies. It also can be devastating to patients, who are needlessly kept from returning to their jobs and families. To cover up the scheme, medical notes are sometimes altered and doctors come up with excuses, such as medication changes, sources allege. Employees say they repeatedly hear the phrase: “don’t leave days on the table.”

The Department of Health and Human Services has been investigating UHS for several years, as Buzzfeed has previously reported. UHS, a $12 billion company, gets a third of its revenue from government insurance providers. In 2013, HHS issued subpoenas to 10 UHS psychiatric hospitals.

But now it seems the Department of Defense and the FBI have also gotten involved.

The article is here.

How Gullible Are We? A Review of the Evidence From Psychology and Social Science.

Hugo Mercier
Review of General Psychology, May 18 , 2017

Abstract

A long tradition of scholarship, from ancient Greece to Marxism or some contemporary social psychology, portrays humans as strongly gullible—wont to accept harmful messages by being unduly deferent. However, if humans are reasonably well adapted, they should not be strongly gullible: they should be vigilant toward communicated information. Evidence from experimental psychology reveals that humans are equipped with well-functioning mechanisms of epistemic vigilance. They check the plausibility of messages against their background beliefs, calibrate their trust as a function of the source’s competence and benevolence, and critically evaluate arguments offered to them. Even if humans are equipped with well-functioning mechanisms of epistemic vigilance, an adaptive lag might render them gullible in the face of new challenges, from clever marketing to omnipresent propaganda. I review evidence from different cultural domains often taken as proof of strong gullibility: religion, demagoguery, propaganda, political campaigns, advertising, erroneous medical beliefs, and rumors. Converging evidence reveals that communication is much less influential than often believed—that religious proselytizing, propaganda, advertising, and so forth are generally not very effective at changing people’s minds. Beliefs that lead to costly behavior are even less likely to be accepted. Finally, it is also argued that most cases of acceptance of misguided communicated information do not stem from undue deference, but from a fit between the communicated information and the audience’s preexisting beliefs.

The article is here.

Friday, June 9, 2017

Sapolsky on the biology of human evil

Sean Illing
Vox.com
Originally posted May 23, 2017

Here is an excerpt:

The key question of the book — why are we the way we are? — is explored from a multitude of angles, and the narrative structure helps guide the reader. For instance, Sapolsky begins by examining a person’s behavior in the moment (why we recoil or rejoice or respond aggressively to immediate stimuli) and then zooms backward in time, following the chain of antecedent causes back to our evolutionary roots.

For every action, Sapolsky shows, there are several layers of causal significance: There’s a neurobiological cause and a hormonal cause and a chemical cause and a genetic cause, and, of course, there are always environmental and historical factors. He synthesizes the research across these disciplines into a coherent, readable whole.

In this interview, I talk with Sapolsky about the paradoxes of human nature, why we’re capable of both good and evil, whether free will exists, and why symbols have become so central to human life.

The article and interview are here.