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, September 27, 2017

New York’s Highest Court Rules Against Physician-Assisted Suicide

Jacob Gershman
The Wall Street Journal
Originally posted September 7, 2017

New York’s highest court on Thursday ruled that physician-assisted suicide isn’t a fundamental right, rejecting a legal effort by terminally ill patients to decriminalize doctor-assisted suicide through the courts.

The state Court of Appeals, though, said it wouldn’t stand in the way if New York’s legislature were to decide that assisted suicide could be “effectively regulated” and pass legislation allowing terminally ill and suffering patients to kill themselves.

Physician-assisted suicide is illegal in most of the country. But advocates who support loosening the laws have been making gains. Doctor-assisted dying has been legalized in several states, most recently in California and Colorado, the former by legislation and the latter by a ballot measure approved by voters in November. Oregon, Vermont and Washington have enacted similar “end-of-life” measures. Washington, D.C., also passed an “assisted-dying” law last year.

Montana’s highest court in 2009 ruled that physicians who provide “aid in dying” are shielded from liability.

No state court has recognized “aid in dying” as a fundamental right.

The article is here.

How to Recognize Burnout Before You’re Burned Out

Kenneth R. Rosen
The New York Times
Originally published September 5, 2017

Here is an excerpt:

In today’s era of workplace burnout, achieving a simpatico work-life relationship seems practically out of reach. Being tired, ambivalent, stressed, cynical and overextended has become a normal part of a working professional life. The General Social Survey of 2016, a nationwide survey that since 1972 has tracked the attitudes and behaviors of American society, found that 50 percent of respondents are consistently exhausted because of work, compared with 18 percent two decades ago.

Where once the term burnout was applied exclusively to health care workers, police officers, firefighters, paramedics or social workers who deal with trauma and human services — think Graham Greene’s novel “A Burnt-Out Case,” about a doctor in the Belgian Congo, a book that gave rise to the term colloquially — the term has since expanded to workers who are now part of a more connected, hyperactive and overcompensating work force.

But occupational burnout goes beyond needing a simple vacation or a family retreat, and many experts, psychologists and institutions, including the Centers for Disease Control and Prevention, highlight long-term and unresolvable burnout as not a symptom but rather a major health concern. (Though it does not appear in the Diagnostic and Statistical Manual of Mental Disorders, which outlines psychiatric disorders, it does appear in the International Statistical Classification of Diseases and Related Health Problems, a classification used by the World Health Organization.)

“We’re shooting ourselves in the foot,” Ms. Seppala told me. “Biologically we are not meant to be in that high-stress mode all the time. We got lost in this idea that the only way to be productive is to be on the go-go-go mode.”

The article is here.

Tuesday, September 26, 2017

The Influence of War on Moral Judgments about Harm

Hanne M Watkins and Simon M Laham
Preprint

Abstract

How does war influence moral judgments about harm? While the general rule is “thou shalt not kill,” war appears to provide an unfortunately common exception to the moral prohibition on intentional harm. In three studies (N = 263, N = 557, N = 793), we quantify the difference in moral judgments across peace and war contexts, and explore two possible explanations for the difference. Taken together, the findings of the present studies have implications for moral psychology researchers who use war based scenarios to study broader cognitive or affective processes. If the war context changes judgments of moral scenarios by triggering group-based reasoning or altering the perceived structure of the moral event, using such scenarios to make “decontextualized” claims about moral judgment may not be warranted.

Here is part of the discussion.

A number of researchers have begun to investigate how social contexts may influence moral judgment, whether those social contexts are grounded in groups (Carnes et al, 2015; Ellemers & van den Bos, 2009) or relationships (Fiske & Rai, 2014; Simpson, Laham, & Fiske, 2015). The war context is another specific context which influences moral judgments: in the present study we found that the intergroup nature of war influenced people’s moral judgments about harm in war – even if they belonged to neither of the two groups actually at war – and that the usually robust difference between switch and footbridge scenarios was attenuated in the war context. One implication of these findings is that some caution may be warranted when using war-based scenarios for studying morality in general. As mentioned in the introduction, scenarios set in war are often used in the study of broad domains or general processes of judgment (e.g. Graham et al., 2009; Phillips & Young, 2011; Piazza et al., 2013). Given the interaction of war context with intergroup considerations and with the construed structure of the moral event in the present studies, researchers are well advised to avoid making generalizations to morality writ large on the basis of war-related scenarios (see also Bauman, McGraw, Bartels, & Warren, 2014; Bloom, 2011).

The preprint is here.

Drug company faked cancer patients to sell drug

Aaron M. Kessler
CNN.com
Originally published September 6, 2017

When Insys Therapeutics got approval to sell an ultra-powerful opioid for cancer patients with acute pain in 2012, it soon discovered a problem: finding enough cancer patients to use the drug.

To boost sales, the company allegedly took patients who didn't have cancer and made it look like they did.

The drug maker used a combination of tactics, such as falsifying medical records, misleading insurance companies and providing kickbacks to doctors in league with the company, according to a federal indictment and ongoing congressional investigation by Sen. Claire McCaskill, a Democrat from Missouri.

The new report by McCaskill's office released Wednesday includes allegations about just how far the company went to push prescriptions of its sprayable form of fentanyl, Subsys.

Because of the high cost associated with Subsys, most insurers wouldn't pay for it unless it was approved in advance. That process, likely familiar to anyone who's taken an expensive medication, is called "prior-authorization."

The article is here.

Monday, September 25, 2017

Science debate: Should we embrace an enhanced future?

Alexander Lees
BBC.com
Originally posted September 9, 2017

Here is an excerpt:

Are we all enhanced?

Most humans are now enhanced to be resistant to many infectious diseases. Vaccination is human enhancement. Apart from "anti-vaxxers" - as those who lobby against childhood inoculations are often dubbed - most of us are content to participate. And society as a whole benefits from being free of those diseases.

So what if we took that a pharmaceutical step further. What if, as well as vaccines against polio, mumps, measles, rubella and TB, everyone also "upgraded" by taking drugs to modify their behaviour? Calming beta-blocker drugs could reduce aggression - perhaps even helping to diffuse racial tension. Or what if we were all prescribed the hormone oxytocin, a substance known to enhance social and family bonds - to just help us all just get along a little better.

Would society function better with these chemical tweaks? And might those who opt out become pariahs for not helping to build a better world - for not wanting to be "vaccinated" against anti-social behaviours?

And what if such chemical upgrades could not be made available to everyone, because of cost or scarcity? Should they be available to no one? An enhanced sense of smell might be useful for a career in wine tasting but not perhaps in rubbish disposal.

A case in point is military research - an arm of which is already an ongoing transhumanism experiment.

Many soldiers on the battlefield routinely take pharmaceuticals as cognitive enhancers to reduce the need to sleep and increase the ability to operate under stress. High tech exoskeletons, increasing strength and endurance, are no longer the realms of science fiction and could soon be in routine military use.

The article is here.

New class of drugs targets aging to help keep you healthy

Jacqueline Howard
CNN.com
Originally published September 5, 2017

Here is an excerpt:

"In the coming decades, I believe that health care will be transformed by this class of medicine and a whole set of diseases that your parents and grandparents have will be things you only see in movies or read in books, things like age-associated arthritis," said David, whose company was not involved in the new paper.

Yet he cautioned that, while many more studies may be on the horizon for senolytic drugs, some might not be successful.

"One thing that people tend to do is, they tend to overestimate things in the short run but then underestimate things in the long run, and I think that, like many fields, this suffers from that as well," David said.

"It will take a while," he said. "I think it's important to recognize that a drug discovery is among the most important of all human activities ... but it takes time, and there must be a recognition of that, and it takes patience."

The article is here.

Sunday, September 24, 2017

Ethics experts say Trump administration far from normal

Rachael Seeley Flores
The Center for Public Integrity
Originally published September 23, 2017

President Donald Trump’s young administration has already sharply diverged from the ethical norms that typically govern the executive branch, exposing vulnerabilities in the system, a small group of ethics experts and former government officials agreed Saturday.

The consensus emerged at a panel titled “Trump, Ethics and the Law” at the Texas Tribune Festival in Austin, Texas. The panel was moderated by Dave Levinthal, a senior reporter at the Center for Public Integrity.

“There have been untidy administrations in the past, but usually it takes a while to see these things develop,” said Ken Starr, a lawyer and judge who served as solicitor general under President George H.W. Bush and is best known for heading the investigation that led to the impeachment of President Bill Clinton.

Ethics laws are based on the idea that norms will be followed, said Walter Shaub, former director of the U.S. Office of Government Ethics (OGE).

“When they’re not followed, we suddenly discover how completely vulnerable our system is,” Shaub said.

The article is here.

The Bush Torture Scandal Isn’t Over

Daniel Engber
Slate.com
Originally published September 5, 2017

In June, a little-known academic journal called Teaching of Psychology published an article about the American Psychological Association’s role in the U.S. government’s war on terror and the interrogation of military detainees. Mitchell Handelsman’s seven-page paper, called “A Teachable Ethics Scandal,” suggested that the seemingly cozy relationship between APA officials and the Department of Defense might be used to illustrate numerous psychological concepts for students including obedience, groupthink, terror management theory, group influence, and motivation.

By mid-July, Teaching of Psychology had taken steps to retract the paper. The thinking that went into that decision reveals a disturbing under-covered coda to a scandal that, for a time, was front-page news. In July 2015, then–APA President Nadine Kaslow apologized for the organization’s involvement in Bush-era enhanced interrogations. “This bleak chapter in our history,” she said, speaking for a group with more than 100,000 members and a nine-figure budget, “occurred over a period of years and will not be resolved in a matter of months.” Two years later, the APA’s attempt to turn the page has devolved into a vicious internecine battle in which former association presidents have taken aim at one another. At issue is the question of who (if anyone) should be blamed for giving the Bush administration what’s been called a “green light” to torture detainees—and when the APA will ever truly get past this scandal.

The article is here.

Saturday, September 23, 2017

Why Buddhism is True with Robert Wright

Scott Barry Kaufman
The Psychology Podcast
August 13, 2017

This week we’re excited to have Robert Wright on The Psychology Podcast. Robert is the New York Times best-selling author of Nonzero, The Moral Animal, The Evolution of God, and most recently Why Buddhism is True. He has also written for The New Yorker, The Atlantic, The New York Times, Time, Slate, and The New Republic, and has taught at The University of Pennsylvania and Princeton University, where he also created the online course Buddhism and Modern Psychology. Robert draws on his wide-ranging knowledge of science, religion, psychology, history and politics to figure out what makes humanity tick.




Note from John: If you are a psychologist and cannot read Why Buddhism is True, then this is your next best option.  This book is really good and I highly recommend it.