Should a rapist get Viagra or a robber get a cataracts op?

Tom Douglas

Aeon Magazine

Originally published on July 7, 2017

Suppose a physician is about to treat a patient for diminished sex drive when she discovers that the patient – let’s call him Abe – has raped several women in the past. Fearing that boosting his sex drive might lead Abe to commit further sex offences, she declines to offer the treatment. Refusal to provide medical treatment in this case strikes many as reasonable. It might not be entirely unproblematic, since some will argue that he has a human right to medical treatment, but many of us would probably think the physician is within her rights – she’s not obliged to treat Abe. At least, not if her fears about further offending are well-founded.

But now consider a different case. Suppose an eye surgeon is about to book Bert in for a cataract operation when she discovers that he is a serial bank robber. Fearing that treating his developing blindness might help Bert to carry off further heists, she declines to offer the operation. In many ways, this case mirrors that of Abe. But morally, it seems different. In this case, refusing treatment does not seem reasonable, no matter how well-founded the surgeon’s fear. What’s puzzling is why. Why is Bert’s surgeon obliged to treat his blindness, while Abe’s physician has no similar obligation to boost his libido?

Here’s an initial suggestion: diminished libido, it might be said, is not a ‘real disease’. An inconvenience, certainly. A disability, perhaps. But a genuine pathology? No. By contrast, cataract disease clearly is a true pathology. So – the argument might go – Bert has a stronger claim to treatment than Abe. But even if reduced libido is not itself a disease – a view that could be contested – it could have pathological origins. Suppose Abe has a disease that suppresses testosterone production, and thus libido. And suppose that the physician’s treatment would restore his libido by correcting this disease. Still, it would seem reasonable for her to refuse the treatment, if she had good grounds to believe providing it could result in further sex offences.

The article is here.

A new breed of scientist, with brains of silicon

John Bohannon
Science Magazine
Originally published July 5, 2017

Here is an excerpt:

But here’s the key difference: When the robots do finally discover the genetic changes that boost chemical output, they don’t have a clue about the biochemistry behind their effects.

Is it really science, then, if the experiments don’t deepen our understanding of how biology works? To Kimball, that philosophical point may not matter. “We get paid because it works, not because we understand why.”

So far, Hoffman says, Zymergen’s robotic lab has boosted the efficiency of chemical-producing microbes by more than 10%. That increase may not sound like much, but in the $160-billion-per-year sector of the chemical industry that relies on microbial fermentation, a fractional improvement could translate to more money than the entire $7 billion annual budget of the National Science Foundation. And the advantageous genetic changes that the robots find represent real discoveries, ones that human scientists probably wouldn’t have identified. Most of the output-boosting genes are not directly related to synthesizing the desired chemical, for instance, and half have no known function. “I’ve seen this pattern now in several different microbes,” Dean says. Finding the right genetic combinations without machine learning would be like trying to crack a safe with thousands of numbers on its dial. “Our intuitions are easily overwhelmed by the complexity,” he says.

The article is here.

GOP Lawmakers Buy Health Insurance Stocks as Repeal Efforts Move Forward

Lee Fang
The Intercept
Originally posted July 6, 2017

Here is an excerpt:

The issue of insider political trading, with members and staff buying and selling stock using privileged information, has continued to plague Congress. It gained national prominence during the confirmation hearings for Health and Human Services Secretary Tom Price, when it was revealed that the Georgia Republican had bought shares in Innate Immunotherapeutics, a relatively obscure Australian biotechnology firm, while legislating on policies that could have impacted the firm’s performance.

The stock advice had been passed to Price from Rep. Chris Collins, R-N.Y., a board member for Innate Immunotherapeutics, and was shared with a number of other GOP lawmakers, who also invested in the firm. Conaway, records show, bought shares in the company a week after Price.

Conaway, who serves as a GOP deputy whip in the House, has a long record of investing in firms that coincide with his official duties. Politico reported that Conaway’s wife purchased stock in a nuclear firm just after Conaway sponsored a bill to deal with nuclear waste storage in his district. The firm stood to directly benefit from the legislation.

Some of the biggest controversies stem from the revelation that during the 2008 financial crisis, multiple lawmakers from both parties rearranged their financial portfolios to avoid heavy losses. In one case, former Rep. Spencer Baucus, R-Ala., used confidential meetings about the unfolding bank crisis to make special trades designed to increase in value as the stock market plummeted.

The article is here.

Even the Insured Often Can't Afford Their Medical Bills

Helaine Olen
The Atlantic
Originally published June 18, 2017

Here is an excerpt:

The current debate over the future of the Affordable Care Act is obscuring a more pedestrian reality. Just because a person is insured, it doesn’t mean he or she can actually afford their doctor, hospital, pharmaceutical, and other medical bills. The point of insurance is to protect patients’ finances from the costs of everything from hospitalizations to prescription drugs, but out-of-pocket spending for people even with employer-provided health insurance has increased by more than 50 percent since 2010, according to human resources consultant Aon Hewitt. The Kaiser Family Foundation reports that in 2016, half of all insurance policy-holders faced a deductible, the amount people need to pay on their own before their insurance kicks in, of at least $1,000. For people who buy their insurance via one of the Affordable Care Act’s exchanges, that figure will be higher still: Almost 90 percent have deductibles of $1,300 for an individual or $2,600 for a family.

Even a gold-plated insurance plan with a low deductible and generous reimbursements often has its holes. Many people have separate—and often hard-to-understand—in-network and out-of-network deductibles, or lack out-of-network coverage altogether.  Expensive pharmaceuticals are increasingly likely to require a significantly higher co-pay or not be covered at all. While many plans cap out-of-pocket spending, that cap can often be quite high—in 2017, it’s $14,300 for a family plan purchased on the ACA exchanges, for example. Depending on the plan, medical care received from a provider not participating in a particular insurer’s network might not count toward any deductible or cap at all.

The article is here.

Stop Obsessing Over Race and IQ

John McWhorter
The National Review
Originally published July 5, 2017

Here are three excerpts:

Suppose that, at the end of the day, people of African descent have lower IQs on average than do other groups of humans, and that this gap is caused, at least in part, by genetic differences.

(cut)

There is, however, a question that those claiming black people are genetically predisposed to have lower IQs than others fail to answer: What, precisely, would we gain from discussing this particular issue?

(cut)

A second purpose of being “honest” about a racial IQ gap would be the opposite of the first: We might take the gap as a reason for giving not less but more attention to redressing race-based inequities. That is, could we imagine an America in which it was accepted that black people labored — on average, of course — under an intellectual handicap, and an enlightened, compassionate society responded with a Great Society–style commitment to the uplift of the people thus burdened?

I am unaware of any scholar or thinker who has made this argument, perhaps because it, too, is an obvious fantasy. Officially designating black people as a “special needs” race perpetually requiring compensatory assistance on the basis of their intellectual inferiority would run up against the same implacable resistance as condemning them to menial roles for the same reason. The impulse that rejects the very notion of IQ differences between races will thrive despite any beneficent intentions founded on belief in such differences.

The article is here.

Mapping Cognitive Structure onto the Landscape of Philosophical Debate

An Empirical Framework with Relevance to Problems of Consciousness, Free will and Ethics

Jared P. Friedman & Anthony I. Jack
Review of Philosophy and Psychology
pp 1–41

Abstract

There has been considerable debate in the literature as to whether work in experimental philosophy (X-Phi) actually makes any significant contribution to philosophy. One stated view is that many X-Phi projects, notwithstanding their focus on topics relevant to philosophy, contribute little to philosophical thought. Instead, it has been claimed the contribution they make appears to be to cognitive science. In contrast to this view, here we argue that at least one approach to X-Phi makes a contribution which parallels, and also extends, historically salient forms of philosophical analysis, especially contributions from Immanuel Kant, William James, Peter F. Strawson and Thomas Nagel. The framework elaborated here synthesizes philosophical theory with empirical evidence from psychology and neuroscience and applies it to three perennial philosophical problems. According to this account, the origin of these three problems can be illuminated by viewing them as arising from a tension between two distinct types of cognition, each of which is associated with anatomically independent and functionally inhibitory neural networks. If the parallel we draw, between an empirical project and historically highly influential examples of philosophical analysis, is viewed as convincing, it follows that work in the cognitive sciences can contribute directly to philosophy. Further, this conclusion holds whether the empirical details of the account are correct or not.

The article is here.

Judgment Before Emotion: People Access Moral Evaluations Faster than Affective States

Corey Cusimano, Stuti Thapa Magar, & Bertram F. Malle

Abstract

Theories about the role of emotions in moral cognition make different predictions about the relative speed of moral and affective judgments: those that argue that felt emotions are causal inputs to moral judgments predict that recognition of affective states should precede moral judgments; theories that posit emotional states as the output of moral judgment predict the opposite. Across four studies, using a speeded reaction time task, we found that self-reports of felt emotion were delayed relative to reports of event-directed moral judgments (e.g. badness) and were no faster than person directed moral judgments (e.g. blame). These results pose a challenge to prominent theories arguing that moral judgments are made on the basis of reflecting on affective states.

The article is here.

Enabling torture: APA, clinical psychology training and the failure to disobey.

Alice LoCicero, Robert P. Marlin, David Jull-Patterson, Nancy M. Sweeney, Brandon Lee Gray, & J. Wesley Boyd
Peace and Conflict: Journal of Peace Psychology, Vol 22(4), Nov 2016, 345-355.

Abstract

The American Psychological Association (APA) has historically had close ties with the U.S. Department of Defense (DOD). Recent revelations describe problematic outcomes of those ties, as some in the APA colluded with the DOD to allow psychologists to participate, with expectation of impunity, in harsh interrogations that amounted to torture of Guantanamo detainees, during the Bush era. We now know that leaders in the APA purposely misled psychologists about the establishment of policies on psychologists’ roles in interrogations. Still, the authors wondered why, when the resulting policies reflected a clear contradiction of the fundamental duty to do no harm, few psychologists, in or out of the military, protested the policies articulated in 2005 by the committee on Psychological Ethics and National Security (PENS). Previous research suggested that U.S. graduate students in clinical psychology receive little or no training in the duties of psychologists in military settings or in the ethical guidance offered by international treaties. Thus psychologists might not have been well prepared to critique the PENS policies or to refuse to participate in interrogations. To further explore this issue, the authors surveyed Directors of Clinical Training of doctoral programs in clinical psychology, asking how extensively their programs address dilemmas psychologists may face in military settings. The results indicate that most graduate programs offer little attention to dilemmas of unethical orders, violations of international conventions, or excessively harsh interrogations. These findings, combined with earlier studies, suggest that military psychologists may have been unprepared to address ethical dilemmas, whereas psychologists outside the military may have been unprepared to critique the APA’s collusion with the DOD. The authors suggest ways to address this apparent gap in ethics education for psychology graduate students, interns, and fellows.

The article is here.

A Proposal for a Scientifically-Informed and Instrumentalist Account of Free Will and Voluntary Action

Eric Racine
Frontiers in Psychology, 17 May 2017

Here is an excerpt:

From the perspective of applied ethics and social behavior, voluntariness is a key dimension in the understanding of autonomous decisions and actions as well as our responsibility toward and ownership of these decisions and actions (Dworkin, 1988; Wegner, 2002). Autonomous decisions and actions imply that the agent is initiating them according to his or her own wishes and that the person is free to do so (i.e., not under direct or indirect forms of coercion that would imperil the existence of such an ability). Accordingly, in applied ethics, voluntariness commonly refers to “the degree that [the moral agent] wills the action without being under the control of another's influence” (Beauchamp and Childress, 2001). Indeed, if moral agents have a jeopardized ability, or even lack the ability to initiate actions freely, then neither can they be faulted for their own actions (responsibility) nor encouraged to undertake actions on the premise of their expression of their own preferences (autonomy; Felsen and Reiner, 2011; Castelo et al., 2012). The concept of FW commonly captures a basic form of agency and a responsibility associated with this ability to self-control and initiate voluntary action (Roskies, 2006; Brass et al., 2013). Accordingly, in this paper, FW designates primarily a basic ability to envision options and choose between them such that the will or volition of the person is considered to be free.

The article is here.

Editor's note: The concept of free will is a main concern in psychotherapy.  How autonomous is your patient's behavior?