Simon Usborne
The Guardian
Originally published August 1, 2017
Here is an excerpt:
They call it “Zero Suicide”, a bold ambition and slogan that emerged from a Detroit hospital more than a decade ago, and which is now being incorporated into several NHS trusts. Since our first meeting, Steve has himself embraced the idea, and in May of this year held talks with Mersey Care, one of the specialist mental health trusts already applying a zero strategy. His plans are at an early stage, but he is setting out to create a Zero Suicide foundation. He wants it to identify good practices across the 55 mental health trusts in England and create a new strategy to be applied everywhere.
The zero approach is a proactive strategy that aims to identify and care for all those who may be at risk of suicide, rather than reacting once patients have reached crisis point. It emphasises strong leadership, improved training, better patient-screening and the use of the latest data and research to make changes without fear or delay. It is a joined-up strategy that challenges old ideas about the inevitability of suicide, the stigma that surrounds it, and the idea that if a reduction target is achieved, the deaths on the way to it are somehow acceptable. “Even if you believe we are never going to eradicate suicide, we must strive towards that,” Steve said to me. “If zero isn’t the right target, then what is?”
Zero Suicide is not radical, incorporating as it does several existing prevention strategies. But that it should be seen as new and daringly ambitious reveals much about how slowly attitudes have changed. In the 1957 book The Uses of Literacy: Aspects of Working-Class Life, a semi-autobiographical examination of the cultural upheavals of the 1950s, Richard Hoggart recalled his upbringing in Leeds. “Every so often one heard that so-and-so had ‘done ’erself in’ … or ‘put ’er ’ead in the gas-oven’,” he wrote. “It did not happen monthly or even every season, and not all attempts succeeded; but it happened sufficiently often to be part of the pattern of life.” He wondered how “suicide could be accepted – pitifully but with little suggestion of blame – as part of the order of existence”.
The article is here.
Sunday, September 3, 2017
Saturday, September 2, 2017
Mr. Rogers and the Power of Persuasion
Will Schoder
Published on Jun 17, 2017
Produced by Yellow Bear Films
Published on Jun 17, 2017
Produced by Yellow Bear Films
Friday, September 1, 2017
A Plutocratic Proposal: an ethical way for rich patients to pay for a place on a clinical trial
Alexander Masters and Dominic Nutt
Journal of Medical Ethics
Published Online First: 06 June 2017.
Abstract
Many potential therapeutic agents are discarded before they are tested in humans. These are not quack medications. They are drugs and other interventions that have been developed by responsible scientists in respectable companies or universities and are often backed up by publications in peer-reviewed journals. These possible treatments might ease suffering and prolong the lives of innumerable patients, yet they have been put aside. In this paper, we outline a novel mechanism—the Plutocratic Proposal—to revive such neglected research and fund early phase clinical trials. The central idea of the Proposal is that any patient who rescues a potential therapeutic agent from neglect by funding early phase clinical trials (either entirely or in large part) should be offered a place on the trial.
The article is here.
Journal of Medical Ethics
Published Online First: 06 June 2017.
Abstract
Many potential therapeutic agents are discarded before they are tested in humans. These are not quack medications. They are drugs and other interventions that have been developed by responsible scientists in respectable companies or universities and are often backed up by publications in peer-reviewed journals. These possible treatments might ease suffering and prolong the lives of innumerable patients, yet they have been put aside. In this paper, we outline a novel mechanism—the Plutocratic Proposal—to revive such neglected research and fund early phase clinical trials. The central idea of the Proposal is that any patient who rescues a potential therapeutic agent from neglect by funding early phase clinical trials (either entirely or in large part) should be offered a place on the trial.
The article is here.
Political differences in free will belief are driven by differences in moralization
Clark, C. J., Everett, J. A. C., Luguri, J. B., Earp, B. D., Ditto, P., & Shariff, A.
PsyArXiv. (2017, August 1).
Abstract
Five studies tested whether political conservatives’ stronger free will beliefs are driven by their broader view of morality, and thus a broader motivation to assign responsibility. On an individual difference level, Study 1 found that political conservatives’ higher moral wrongness judgments accounted for their higher belief in free will.In Study 2, conservatives ascribed more free will for negative events than liberals,while no differences emerged for positive events. For actions ideologically equivalent in perceived moral wrongness, free will judgments also did not differ (Study 3), and actions that liberals perceived as more wrong, liberals judged as more free(Study 4). Finally, higher wrongness judgments mediated the effect of conservatism on free will beliefs(Study 5). Higher free will beliefs among conservatives may be explained by conservatives’ tendency to moralize, which strengthens motivation to justify blame with stronger belief in free will and personal accountability.
The preprint research article is here.
PsyArXiv. (2017, August 1).
Abstract
Five studies tested whether political conservatives’ stronger free will beliefs are driven by their broader view of morality, and thus a broader motivation to assign responsibility. On an individual difference level, Study 1 found that political conservatives’ higher moral wrongness judgments accounted for their higher belief in free will.In Study 2, conservatives ascribed more free will for negative events than liberals,while no differences emerged for positive events. For actions ideologically equivalent in perceived moral wrongness, free will judgments also did not differ (Study 3), and actions that liberals perceived as more wrong, liberals judged as more free(Study 4). Finally, higher wrongness judgments mediated the effect of conservatism on free will beliefs(Study 5). Higher free will beliefs among conservatives may be explained by conservatives’ tendency to moralize, which strengthens motivation to justify blame with stronger belief in free will and personal accountability.
The preprint research article is here.
Thursday, August 31, 2017
Stress Leads to Bad Decisions. Here’s How to Avoid Them
Ron Carucci
Harvard Business Review
Originally posted August 29, 2017
Here is an excerpt:
Facing high-risk decisions.
For routine decisions, most leaders fall into one of two camps: The “trust your gut” leader makes highly intuitive decisions, and the “analyze everything” leader wants lots of data to back up their choice. Usually, a leader’s preference for one of these approaches poses minimal threat to the decision’s quality. But the stress caused by a high-stakes decision can provoke them to the extremes of their natural inclination. The highly intuitive leader becomes impulsive, missing critical facts. The highly analytical leader gets paralyzed in data, often failing to make any decision. The right blend of data and intuition applied to carefully constructing a choice builds the organization’s confidence for executing the decision once made. Clearly identify the risks inherent in the precedents underlying the decision and communicate that you understand them. Examine available data sets, identify any conflicting facts, and vet them with appropriate stakeholders (especially superiors) to make sure your interpretations align. Ask for input from others who’ve faced similar decisions. Then make the call.
Solving an intractable problem.
To a stressed-out leader facing a chronic challenge, it often feels like their only options are to either (1) vehemently argue for their proposed solution with unyielding certainty, or (2) offer ideas very indirectly to avoid seeming domineering and to encourage the team to take ownership of the challenge. The problem, again, is that neither extreme works. If people feel the leader is being dogmatic, they will disengage regardless of the merits of the idea. If they feel the leader lacks confidence in the idea, they will struggle to muster conviction to try it, concluding, “Well, if the boss isn’t all that convinced it will work, I’m not going to stick my neck out.”
The article is here.
Harvard Business Review
Originally posted August 29, 2017
Here is an excerpt:
Facing high-risk decisions.
For routine decisions, most leaders fall into one of two camps: The “trust your gut” leader makes highly intuitive decisions, and the “analyze everything” leader wants lots of data to back up their choice. Usually, a leader’s preference for one of these approaches poses minimal threat to the decision’s quality. But the stress caused by a high-stakes decision can provoke them to the extremes of their natural inclination. The highly intuitive leader becomes impulsive, missing critical facts. The highly analytical leader gets paralyzed in data, often failing to make any decision. The right blend of data and intuition applied to carefully constructing a choice builds the organization’s confidence for executing the decision once made. Clearly identify the risks inherent in the precedents underlying the decision and communicate that you understand them. Examine available data sets, identify any conflicting facts, and vet them with appropriate stakeholders (especially superiors) to make sure your interpretations align. Ask for input from others who’ve faced similar decisions. Then make the call.
Solving an intractable problem.
To a stressed-out leader facing a chronic challenge, it often feels like their only options are to either (1) vehemently argue for their proposed solution with unyielding certainty, or (2) offer ideas very indirectly to avoid seeming domineering and to encourage the team to take ownership of the challenge. The problem, again, is that neither extreme works. If people feel the leader is being dogmatic, they will disengage regardless of the merits of the idea. If they feel the leader lacks confidence in the idea, they will struggle to muster conviction to try it, concluding, “Well, if the boss isn’t all that convinced it will work, I’m not going to stick my neck out.”
The article is here.
Wednesday, August 30, 2017
Vignette 36: The Cancellation Conundrum
Dr. Wendy Malik operates an independent practice in a suburban area. She receives a referral from a physician, with whom she has a positive working relationship. Dr. Malik contacts the patient, completes a phone screening, and sets up an appointment with Mr. Larry David.
As is her practice, Dr. Malik sends a confirmation email, attaching her version of informed consent. She instructs Mr. David that he does not have to print it out, only review it and they would discuss any questions at the initial appointment.
Several days later, Dr. Malik checks her email. In it, Mr. David sent her an email with an attachment. Mr. David asks Dr. Malik to review his edits on the informed consent document.
While Dr. Malik notes some suggested corrections on the document, Mr. David modified the cancellation policy. Dr. Malik’s form (and standard policy) is appointments cancelled with less than 24-hour notice will be charged to the patient. Mr. David added a sentence that if Dr. Malik cancels an appointment with less than 24 hours, Mr. David expects Dr. Malik to pay him an amount equal to her hourly rate.
Flustered by this edit, Dr. Malik contacts you for a consultation.
What are the ethical issues involved in this case?
What are the pertinent clinical issues in this case?
How would you help Dr. Malik work through these issues?
Would you recommend Dr. Malik call to address the issue ahead of the appointment or wait for the initial session?
At this point, must Dr. Malik keep Mr. David as a patient?
If not, does Dr. Malik need to contact her referral source about the issue?
As is her practice, Dr. Malik sends a confirmation email, attaching her version of informed consent. She instructs Mr. David that he does not have to print it out, only review it and they would discuss any questions at the initial appointment.
Several days later, Dr. Malik checks her email. In it, Mr. David sent her an email with an attachment. Mr. David asks Dr. Malik to review his edits on the informed consent document.
While Dr. Malik notes some suggested corrections on the document, Mr. David modified the cancellation policy. Dr. Malik’s form (and standard policy) is appointments cancelled with less than 24-hour notice will be charged to the patient. Mr. David added a sentence that if Dr. Malik cancels an appointment with less than 24 hours, Mr. David expects Dr. Malik to pay him an amount equal to her hourly rate.
Flustered by this edit, Dr. Malik contacts you for a consultation.
What are the ethical issues involved in this case?
What are the pertinent clinical issues in this case?
How would you help Dr. Malik work through these issues?
Would you recommend Dr. Malik call to address the issue ahead of the appointment or wait for the initial session?
At this point, must Dr. Malik keep Mr. David as a patient?
If not, does Dr. Malik need to contact her referral source about the issue?
Fat Shaming in the Doctor's Office Can Be Mentally and Physically Harmful
American Psychological Association
Press Release from August 3, 2017
Medical discrimination based on people’s size and negative stereotypes of overweight people can take a toll on people’s physical health and well-being, according to a review of recent research presented at the 125th Annual Convention of the American Psychological Association.
“Disrespectful treatment and medical fat shaming, in an attempt to motivate people to change their behavior, is stressful and can cause patients to delay health care seeking or avoid interacting with providers,” presenter Joan Chrisler, PhD, a professor of psychology at Connecticut College, said during a symposium titled “Weapons of Mass Distraction — Confronting Sizeism.”
Sizeism can also have an effect on how doctors medically treat patients, as overweight people are often excluded from medical research based on assumptions about their health status, Chrisler said, meaning the standard dosage for drugs may not be appropriate for larger body sizes. Recent studies have shown frequent under-dosing of overweight patients who were prescribed antibiotics and chemotherapy, she added.
“Recommending different treatments for patients with the same condition based on their weight is unethical and a form of malpractice,” Chrisler said. “Research has shown that doctors repeatedly advise weight loss for fat patients while recommending CAT scans, blood work or physical therapy for other, average weight patients.”
In some cases, providers might not take fat patients’ complaints seriously or might assume that their weight is the cause of any symptoms they experience, Chrisler added. “Thus, they could jump to conclusions or fail to run appropriate tests, which results in misdiagnosis,” she said.
The pressor is here.
Press Release from August 3, 2017
Medical discrimination based on people’s size and negative stereotypes of overweight people can take a toll on people’s physical health and well-being, according to a review of recent research presented at the 125th Annual Convention of the American Psychological Association.
“Disrespectful treatment and medical fat shaming, in an attempt to motivate people to change their behavior, is stressful and can cause patients to delay health care seeking or avoid interacting with providers,” presenter Joan Chrisler, PhD, a professor of psychology at Connecticut College, said during a symposium titled “Weapons of Mass Distraction — Confronting Sizeism.”
Sizeism can also have an effect on how doctors medically treat patients, as overweight people are often excluded from medical research based on assumptions about their health status, Chrisler said, meaning the standard dosage for drugs may not be appropriate for larger body sizes. Recent studies have shown frequent under-dosing of overweight patients who were prescribed antibiotics and chemotherapy, she added.
“Recommending different treatments for patients with the same condition based on their weight is unethical and a form of malpractice,” Chrisler said. “Research has shown that doctors repeatedly advise weight loss for fat patients while recommending CAT scans, blood work or physical therapy for other, average weight patients.”
In some cases, providers might not take fat patients’ complaints seriously or might assume that their weight is the cause of any symptoms they experience, Chrisler added. “Thus, they could jump to conclusions or fail to run appropriate tests, which results in misdiagnosis,” she said.
The pressor is here.
Tuesday, August 29, 2017
Must science be testable?
Massimo Pigliucci
Aeon
Originally published August 10, 2016
Here is an excerpt:
hat said, the publicly visible portion of the physics community nowadays seems split between people who are openly dismissive of philosophy and those who think they got the pertinent philosophy right but their ideological opponents haven’t. At stake isn’t just the usually tiny academic pie, but public appreciation of and respect for both the humanities and the sciences, not to mention millions of dollars in research grants (for the physicists, not the philosophers). Time, therefore, to take a more serious look at the meaning of Popper’s philosophy and why it is still very much relevant to science, when properly understood.
As we have seen, Popper’s message is deceptively simple, and – when repackaged in a tweet – has in fact deceived many a smart commentator in underestimating the sophistication of the underlying philosophy. If one were to turn that philosophy into a bumper sticker slogan it would read something like: ‘If it ain’t falsifiable, it ain’t science, stop wasting your time and money.’
But good philosophy doesn’t lend itself to bumper sticker summaries, so one cannot stop there and pretend that there is nothing more to say. Popper himself changed his mind throughout his career about a number of issues related to falsification and demarcation, as any thoughtful thinker would do when exposed to criticisms and counterexamples from his colleagues. For instance, he initially rejected any role for verification in establishing scientific theories, thinking that it was far too easy to ‘verify’ a notion if one were actively looking for confirmatory evidence. Sure enough, modern psychologists have a name for this tendency, common to laypeople as well as scientists: confirmation bias.
Nonetheless, later on Popper conceded that verification – especially of very daring and novel predictions – is part of a sound scientific approach. After all, the reason Einstein became a scientific celebrity overnight after the 1919 total eclipse is precisely because astronomers had verified the predictions of his theory all over the planet and found them in satisfactory agreement with the empirical data.
The article is here.
Aeon
Originally published August 10, 2016
hat said, the publicly visible portion of the physics community nowadays seems split between people who are openly dismissive of philosophy and those who think they got the pertinent philosophy right but their ideological opponents haven’t. At stake isn’t just the usually tiny academic pie, but public appreciation of and respect for both the humanities and the sciences, not to mention millions of dollars in research grants (for the physicists, not the philosophers). Time, therefore, to take a more serious look at the meaning of Popper’s philosophy and why it is still very much relevant to science, when properly understood.
As we have seen, Popper’s message is deceptively simple, and – when repackaged in a tweet – has in fact deceived many a smart commentator in underestimating the sophistication of the underlying philosophy. If one were to turn that philosophy into a bumper sticker slogan it would read something like: ‘If it ain’t falsifiable, it ain’t science, stop wasting your time and money.’
But good philosophy doesn’t lend itself to bumper sticker summaries, so one cannot stop there and pretend that there is nothing more to say. Popper himself changed his mind throughout his career about a number of issues related to falsification and demarcation, as any thoughtful thinker would do when exposed to criticisms and counterexamples from his colleagues. For instance, he initially rejected any role for verification in establishing scientific theories, thinking that it was far too easy to ‘verify’ a notion if one were actively looking for confirmatory evidence. Sure enough, modern psychologists have a name for this tendency, common to laypeople as well as scientists: confirmation bias.
Nonetheless, later on Popper conceded that verification – especially of very daring and novel predictions – is part of a sound scientific approach. After all, the reason Einstein became a scientific celebrity overnight after the 1919 total eclipse is precisely because astronomers had verified the predictions of his theory all over the planet and found them in satisfactory agreement with the empirical data.
The article is here.
The Influence of (Dis)belief in Free Will on Immoral Behavior
Caspar, E. A., Vuillaume, L., Magalhães De Saldanha da Gama, P. A. and Cleeremans, A.
Frontiers in Psychology, 17 January 2017
Abstract
One of the hallmarks of human existence is that we all hold beliefs that determine how we act. Amongst such beliefs, the idea that we are endowed with free will appears to be linked to prosocial behaviors, probably by enhancing the feeling of responsibility of individuals over their own actions. However, such effects appear to be more complex that one might have initially thought. Here, we aimed at exploring how induced disbeliefs in free will impact the sense of agency over the consequences of one’s own actions in a paradigm that engages morality. To do so, we asked participants to choose to inflict or to refrain from inflicting an electric shock to another participant in exchange of a small financial benefit. Our results show that participants who were primed with a text defending neural determinism – the idea that humans are a mere bunch of neurons guided by their biology – administered fewer shocks and were less vindictive toward the other participant. Importantly, this finding only held for female participants. These results show the complex interaction between gender, (dis)beliefs in free will and moral behavior.
From the Conclusion:
To conclude, we observed that disbelief in free will had a positive impact on the morality of decisions toward others. The present work extends previous research by showing that additional factors, such as gender, could influence the impact of (dis)belief in free will on prosocial and antisocial behaviors. Our results also showed that previous results relative to the (moral) context underlying the paradigm in use are not always replicated.
The research is here.
Frontiers in Psychology, 17 January 2017
Abstract
One of the hallmarks of human existence is that we all hold beliefs that determine how we act. Amongst such beliefs, the idea that we are endowed with free will appears to be linked to prosocial behaviors, probably by enhancing the feeling of responsibility of individuals over their own actions. However, such effects appear to be more complex that one might have initially thought. Here, we aimed at exploring how induced disbeliefs in free will impact the sense of agency over the consequences of one’s own actions in a paradigm that engages morality. To do so, we asked participants to choose to inflict or to refrain from inflicting an electric shock to another participant in exchange of a small financial benefit. Our results show that participants who were primed with a text defending neural determinism – the idea that humans are a mere bunch of neurons guided by their biology – administered fewer shocks and were less vindictive toward the other participant. Importantly, this finding only held for female participants. These results show the complex interaction between gender, (dis)beliefs in free will and moral behavior.
From the Conclusion:
To conclude, we observed that disbelief in free will had a positive impact on the morality of decisions toward others. The present work extends previous research by showing that additional factors, such as gender, could influence the impact of (dis)belief in free will on prosocial and antisocial behaviors. Our results also showed that previous results relative to the (moral) context underlying the paradigm in use are not always replicated.
The research is here.
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