Science Daily
Originally posted October 2, 2017
Summary: Discussing hospital errors with patients leads to better patient safety without spurring a barrage of malpractice claims, new research shows.
In patient injury cases, revealing facts, offering apology does not lead to increase in lawsuits, study finds
Sometimes a straightforward explanation and an apology for what went wrong in the hospital goes a long way toward preventing medical malpractice litigation and improving patient safety.
That's what Michelle Mello, JD, PhD, and her colleagues found in a study to be published Oct. 2 in Health Affairs.
Mello, a professor of health research and policy and of law at Stanford University, is the lead author of the study. The senior author is Kenneth Sands, former senior vice president at Beth Israel Deaconess Medical Center.
Medical injuries are a leading cause of death in the United States. The lawsuits they spawn are also a major concern for physicians and health care facilities. So, hospital risk managers and liability insurers are experimenting with new approaches to resolving these disputes that channel them away from litigation.
The focus is on meeting patients' needs without requiring them to sue. Hospitals disclose accidents to patients, investigate and explain why they occurred, apologize and, in cases in which the harm was due to a medical error, offer compensation and reassurance that steps will be taken to keep it from happening again.
The article is here.
The target article is here.
Thursday, October 26, 2017
DeepMind launches new research team to investigate AI ethics
James Vincent
The Verge
Originally posted October 4, 2017
Google’s AI subsidiary DeepMind is getting serious about ethics. The UK-based company, which Google bought in 2014, today announced the formation of a new research group dedicated to the thorniest issues in artificial intelligence. These include the problems of managing AI bias; the coming economic impact of automation; and the need to ensure that any intelligent systems we develop share our ethical and moral values.
DeepMind Ethics & Society (or DMES, as the new team has been christened) will publish research on these topics and others starting early 2018. The group has eight full-time staffers at the moment, but DeepMind wants to grow this to around 25 in a year’s time. The team has six unpaid external “fellows” (including Oxford philosopher Nick Bostrom, who literally wrote the book on AI existential risk) and will partner with academic groups conducting similar research, including The AI Now Institute at NYU, and the Leverhulme Centre for the Future of Intelligence.
The article is here.
The Verge
Originally posted October 4, 2017
Google’s AI subsidiary DeepMind is getting serious about ethics. The UK-based company, which Google bought in 2014, today announced the formation of a new research group dedicated to the thorniest issues in artificial intelligence. These include the problems of managing AI bias; the coming economic impact of automation; and the need to ensure that any intelligent systems we develop share our ethical and moral values.
DeepMind Ethics & Society (or DMES, as the new team has been christened) will publish research on these topics and others starting early 2018. The group has eight full-time staffers at the moment, but DeepMind wants to grow this to around 25 in a year’s time. The team has six unpaid external “fellows” (including Oxford philosopher Nick Bostrom, who literally wrote the book on AI existential risk) and will partner with academic groups conducting similar research, including The AI Now Institute at NYU, and the Leverhulme Centre for the Future of Intelligence.
The article is here.
Wednesday, October 25, 2017
Cultivating Humility and Diagnostic Openness in Clinical Judgment
John R. Stone
AMA Journal of Ethics. October 2017, Volume 19, Number 10: 970-977.
Abstract
In this case, a physician rejects a patient’s concerns that tainted water is harming the patient and her community. Stereotypes and biases regarding socioeconomic class and race/ethnicity, constraining diagnostic frameworks, and fixed first impressions could skew the physician’s judgment. This paper narratively illustrates how cultivating humility could help the physician truly hear the patient’s suggestions. The discussion builds on the multifaceted concept of cultural humility as a lifelong journey that addresses not only stereotypes and biases but also power inequalities and community inequities. Insurgent multiculturalism is a complementary concept. Through epistemic humility—which includes both intellectual and emotional components—and admitting uncertainty, physicians can enhance patients’ and families’ epistemic authority and health agency.
The article is here.
AMA Journal of Ethics. October 2017, Volume 19, Number 10: 970-977.
Abstract
In this case, a physician rejects a patient’s concerns that tainted water is harming the patient and her community. Stereotypes and biases regarding socioeconomic class and race/ethnicity, constraining diagnostic frameworks, and fixed first impressions could skew the physician’s judgment. This paper narratively illustrates how cultivating humility could help the physician truly hear the patient’s suggestions. The discussion builds on the multifaceted concept of cultural humility as a lifelong journey that addresses not only stereotypes and biases but also power inequalities and community inequities. Insurgent multiculturalism is a complementary concept. Through epistemic humility—which includes both intellectual and emotional components—and admitting uncertainty, physicians can enhance patients’ and families’ epistemic authority and health agency.
The article is here.
Physician licensing laws keep doctors from seeking care
Bab Nellis
Mayo Clinic New Network
Despite growing problems with psychological distress, many physicians avoid seeking mental health treatment due to concern for their license. Mayo Clinic research shows that licensing requirements in many states include questions about past mental health treatments or diagnoses, with the implication that they may limit a doctor's right to practice medicine. The findings appear today in Mayo Clinic Proceedings.
“Clearly, in some states, the questions physicians are required to answer to obtain or renew their license are keeping them from seeking the help they need to recover from burnout and other emotional or mental health issues,” says Liselotte Dyrbye, M.D., a Mayo Clinic physician and first author of the article.
The researchers examined the licensing documents for physicians in all 50 states and Washington, D.C., and renewal applications from 48 states. They also collected data in a national survey of more than 5,800 physicians, including attitudes about seeking mental health care.
Nearly 40 percent of respondents said they would hesitate in seeking professional help for a mental health condition because they feared doing so could have negative impacts on their medical license.
The article is here.
The target article is here.
Mayo Clinic New Network
Despite growing problems with psychological distress, many physicians avoid seeking mental health treatment due to concern for their license. Mayo Clinic research shows that licensing requirements in many states include questions about past mental health treatments or diagnoses, with the implication that they may limit a doctor's right to practice medicine. The findings appear today in Mayo Clinic Proceedings.
“Clearly, in some states, the questions physicians are required to answer to obtain or renew their license are keeping them from seeking the help they need to recover from burnout and other emotional or mental health issues,” says Liselotte Dyrbye, M.D., a Mayo Clinic physician and first author of the article.
The researchers examined the licensing documents for physicians in all 50 states and Washington, D.C., and renewal applications from 48 states. They also collected data in a national survey of more than 5,800 physicians, including attitudes about seeking mental health care.
Nearly 40 percent of respondents said they would hesitate in seeking professional help for a mental health condition because they feared doing so could have negative impacts on their medical license.
The article is here.
The target article is here.
Tuesday, October 24, 2017
Gaslighting, betrayal and the boogeyman: Personal reflections on the American Psychological Association, PENS and the involvement of psychologists in torture
Nina Thomas
International Journal of Applied Psychoanalytic Studies
Abstract
The American Psychological Association's (APA's) sanctioning psychologists' involvement in “enhanced interrogations,” aka torture, authorized by the closely parsed re-interpretation of relevant law by the Bush administration, has roiled the association since it appointed a task force in 2005. The Psychological Ethics and National Security (PENS) task force, its composition, methods and outcomes have brought public shame to the profession, the association and its members. Having served on the task force and been involved in the aftermath, I offer reflections on my role to provide an insider's look at the struggle I experienced over loyalty to principle, profession, colleagues, and the association. Situating what occurred in the course of the PENS process and its aftermath within the framework of Freyd's and her collaborators ‘theory of “betrayal trauma,” in particular “institutional trauma,” I suggest that others too share similar feelings of profound betrayal by an organization with which so many of us have been identified over the course of many years. I explore the ways in which attachments have been challenged and undermined by what occurred. Among the questions I have grappled with are: Was I the betrayed or betrayer, or both? How can similar self-reflection usefully be undertaken both by the association itself and other members about their actions or inactions?
The article is here.
International Journal of Applied Psychoanalytic Studies
Abstract
The American Psychological Association's (APA's) sanctioning psychologists' involvement in “enhanced interrogations,” aka torture, authorized by the closely parsed re-interpretation of relevant law by the Bush administration, has roiled the association since it appointed a task force in 2005. The Psychological Ethics and National Security (PENS) task force, its composition, methods and outcomes have brought public shame to the profession, the association and its members. Having served on the task force and been involved in the aftermath, I offer reflections on my role to provide an insider's look at the struggle I experienced over loyalty to principle, profession, colleagues, and the association. Situating what occurred in the course of the PENS process and its aftermath within the framework of Freyd's and her collaborators ‘theory of “betrayal trauma,” in particular “institutional trauma,” I suggest that others too share similar feelings of profound betrayal by an organization with which so many of us have been identified over the course of many years. I explore the ways in which attachments have been challenged and undermined by what occurred. Among the questions I have grappled with are: Was I the betrayed or betrayer, or both? How can similar self-reflection usefully be undertaken both by the association itself and other members about their actions or inactions?
The article is here.
'The deserving’: Moral reasoning and ideological dilemmas in public responses to humanitarian communications
Irene Bruna Seu
British Journal of Social Psychology 55 (4), pp. 739-755.
Abstract
This paper investigates everyday moral reasoning in relation to donations and prosocial behaviour in a humanitarian context. The discursive analysis focuses on the principles of deservingness which members of the public use to decide who to help and under what conditions. The paper discusses three repertoires of deservingness: 'Seeing a difference', 'Waiting in queues' and 'Something for nothing ' to illustrate participants' dilemmatic reasoning and to examine how the position of 'being deserving' is negotiated in humanitarian crises. Discursive analyses of these dilemmatic repertoires of deservingness identify the cultural and ideological resources behind these constructions and show how humanitarianism intersects and clashes with other ideologies and value systems. The data suggest that a neoliberal ideology, which endorses self-gratification and materialistic and individualistic ethics, and cultural assimilation of helper and receiver play important roles in decisions about humanitarian helping. The paper argues for the need for psychological research to engage more actively with the dilemmas involved in the moral reasoning related to humanitarianism and to contextualize decisions about giving and helping within the socio-cultural and ideological landscape in which the helper operates.
The research is here.
British Journal of Social Psychology 55 (4), pp. 739-755.
Abstract
This paper investigates everyday moral reasoning in relation to donations and prosocial behaviour in a humanitarian context. The discursive analysis focuses on the principles of deservingness which members of the public use to decide who to help and under what conditions. The paper discusses three repertoires of deservingness: 'Seeing a difference', 'Waiting in queues' and 'Something for nothing ' to illustrate participants' dilemmatic reasoning and to examine how the position of 'being deserving' is negotiated in humanitarian crises. Discursive analyses of these dilemmatic repertoires of deservingness identify the cultural and ideological resources behind these constructions and show how humanitarianism intersects and clashes with other ideologies and value systems. The data suggest that a neoliberal ideology, which endorses self-gratification and materialistic and individualistic ethics, and cultural assimilation of helper and receiver play important roles in decisions about humanitarian helping. The paper argues for the need for psychological research to engage more actively with the dilemmas involved in the moral reasoning related to humanitarianism and to contextualize decisions about giving and helping within the socio-cultural and ideological landscape in which the helper operates.
The research is here.
Monday, October 23, 2017
Holding People Responsible for Ethical Violations: The Surprising Benefits of Accusing Others
Jessica A. Kennedy and Maurice E. Schweitzer
Wharton Behavioral Lab
Abstract
Individuals who accuse others of unethical behavior can derive significant benefits. Compared to individuals who do not make accusations, accusers engender greater trust and are perceived to have higher ethical standards. In Study 1, accusations increased trust in the accuser and lowered trust in the target. In Study 2, we find that accusations elevate trust in the accuser by boosting perceptions of the accuser’s ethical standards. In Study 3, we find that accusations boosted both attitudinal and behavioral trust in the accuser, decreased trust in the target, and promoted relationship conflict within the group. In Study 4, we examine the moderating role of moral hypocrisy. Compared to individuals who did not make an accusation, individuals who made an accusation were trusted more if they had acted ethically but not if they had acted unethically. Taken together, we find that accusations have significant interpersonal consequences. In addition to harming accused targets, accusations can substantially benefit accusers.
Here is part of the Discussion:
It is possible, however, that even as accusations promote group conflict, accusations could benefit organizations by enforcing norms and promoting ethical behavior. To ensure ethical conduct, organizations must set an ethical tone (Mayer et al., 2013). To do so, organizations need to encourage detection and punishment of unethical behavior. Punishment of norm violators has been conceptualized as an altruistic behavior (Fehr & Gachter, 2000). Our findings challenge this conceptualization. Rather than reflecting altruism, accusers may derive substantial personal benefits from punishing norm violators. The trust benefits of making an accusation provide a reason for even the most self-interested actors to intervene when they perceive unethical activity. That is, even when self-interest is the norm (e.g., Pillutla & Chen, 1999), individuals have trust incentives to openly oppose unethical behavior.
The research is here.
Wharton Behavioral Lab
Abstract
Individuals who accuse others of unethical behavior can derive significant benefits. Compared to individuals who do not make accusations, accusers engender greater trust and are perceived to have higher ethical standards. In Study 1, accusations increased trust in the accuser and lowered trust in the target. In Study 2, we find that accusations elevate trust in the accuser by boosting perceptions of the accuser’s ethical standards. In Study 3, we find that accusations boosted both attitudinal and behavioral trust in the accuser, decreased trust in the target, and promoted relationship conflict within the group. In Study 4, we examine the moderating role of moral hypocrisy. Compared to individuals who did not make an accusation, individuals who made an accusation were trusted more if they had acted ethically but not if they had acted unethically. Taken together, we find that accusations have significant interpersonal consequences. In addition to harming accused targets, accusations can substantially benefit accusers.
Here is part of the Discussion:
It is possible, however, that even as accusations promote group conflict, accusations could benefit organizations by enforcing norms and promoting ethical behavior. To ensure ethical conduct, organizations must set an ethical tone (Mayer et al., 2013). To do so, organizations need to encourage detection and punishment of unethical behavior. Punishment of norm violators has been conceptualized as an altruistic behavior (Fehr & Gachter, 2000). Our findings challenge this conceptualization. Rather than reflecting altruism, accusers may derive substantial personal benefits from punishing norm violators. The trust benefits of making an accusation provide a reason for even the most self-interested actors to intervene when they perceive unethical activity. That is, even when self-interest is the norm (e.g., Pillutla & Chen, 1999), individuals have trust incentives to openly oppose unethical behavior.
The research is here.
Reciprocity Outperforms Conformity to Promote Cooperation
Angelo Romano, Daniel Balliet
Psychological Sciences
First Published September 6, 2017
Abstract
Evolutionary psychologists have proposed two processes that could give rise to the pervasiveness of human cooperation observed among individuals who are not genetically related: reciprocity and conformity. We tested whether reciprocity outperformed conformity in promoting cooperation, especially when these psychological processes would promote a different cooperative or noncooperative response. To do so, across three studies, we observed participants’ cooperation with a partner after learning (a) that their partner had behaved cooperatively (or not) on several previous trials and (b) that their group members had behaved cooperatively (or not) on several previous trials with that same partner. Although we found that people both reciprocate and conform, reciprocity has a stronger influence on cooperation. Moreover, we found that conformity can be partly explained by a concern about one’s reputation—a finding that supports a reciprocity framework.
The article is here.
Psychological Sciences
First Published September 6, 2017
Abstract
Evolutionary psychologists have proposed two processes that could give rise to the pervasiveness of human cooperation observed among individuals who are not genetically related: reciprocity and conformity. We tested whether reciprocity outperformed conformity in promoting cooperation, especially when these psychological processes would promote a different cooperative or noncooperative response. To do so, across three studies, we observed participants’ cooperation with a partner after learning (a) that their partner had behaved cooperatively (or not) on several previous trials and (b) that their group members had behaved cooperatively (or not) on several previous trials with that same partner. Although we found that people both reciprocate and conform, reciprocity has a stronger influence on cooperation. Moreover, we found that conformity can be partly explained by a concern about one’s reputation—a finding that supports a reciprocity framework.
The article is here.
Sunday, October 22, 2017
A Car Crash And A Mistrial Cast Doubts On Court-Ordered Mental Health Exams
Steve Burger
Side Effect Media: Public Health/Personal Stories
Originally posted September 26, 2017
Here is an excerpt:
Investigating a lie
Fink was often hired by the courts in Indiana, and over the last ten years had performed dozens of these competency evaluations. His scene-of-the-crash confession called into question not only the Loving trial, but every one he ever worked on.
Courts rely on psychologists to assess the mental fitness of defendants, but Fink’s story raises serious questions about how courts determine mental competency in Indiana and what system of oversight is in place to ensure defendants get a valid examination.
The judge declared a mistrial in Caleb Loving’s case, but Fink’s confession prompted a massive months-long investigation in Vanderburgh County.
Hermann led the investigation, working to untangle a mess of nearly 70 cases for which Fink performed exams or testing, determined to discover the extent of the damage he had done.
“A lot of different agencies participated in that investigation,” Herman said. “It was a troubling case, in that someone who was literally hired by the court to come in and testify about something … [was] lying.”
The county auditor’s office provided payment histories of psychologists hired by the courts, and the Evansville Police Department spent hundreds of hours looking through records. The courts helped Hermann get access to the cases that Albert Fink had worked on.
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