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

Monday, December 4, 2017

Psychologist felt 'honest, sincere' before $800K healthcare fraud exposed

John Agar
MLive.com
Originally posted November 21, 2017

A psychologist who defrauded insurance companies of $800,000 spent half of the money on vacations, concert tickets and a mobile-recording business, the government said.

George E. Compton Jr., 63, of Sturgis, was sentenced by U.S. District Judge Gordon Quist to 28 months in prison.

Compton, who pleaded guilty to healthcare fraud, said he was "ashamed" of his actions.

"Until this investigation, I did not hesitate to describe myself as an honest, sincere man," he wrote in a letter to the judge. "Seeing myself from a different perspective has been trying to say the least. ... The worst punishment for my admitted crimes will be the exclusion from the very work I love."

The government said he billed insurance companies for counseling sessions he did not provide, from Jan. 1, 2013, until June 30, 2016.

The article is here.

Sunday, December 3, 2017

Lack of Intellectual Humility Plagues Our Times, Say Researchers

Paul Ratner
BigThink.com
Originally posted November 12, 2017

Researchers from Duke University say that intellectual humility is an important personality trait that has become in short supply in our country.

Intellectual humility is like open-mindedness. It is basically an awareness that your beliefs may be wrong, influencing a person’s ability to make decisions in politics, health and other areas of life. An intellectually humble person can have strong opinions, say the authors, but will still recognize they are not perfect and are willing to be proven wrong.

This trait is not linked to a specific partisan view, with researchers finding no difference in levels of the characteristic between conservatives, liberals, religious or non-religious people. In fact, the scientists possibly managed to put to rest an age-old stereotype, explained the study’s lead author Mark Leary, a professor of psychology and neuroscience at Duke.

The article is here.

Saturday, December 2, 2017

Japanese doctor who exposed a drug too good to be true calls for morality and reforms

Tomoko Otake
Japan Times
Originally posted November 15, 2017

Here is an excerpt:

Kuwajima says the Diovan case is a sobering reminder that large-scale clinical trials published in top medical journals should not be blindly trusted, as they can be exploited by drugmakers rushing to sell their products before their patents run out.

“I worked at a research hospital and had opportunities to try new or premarket drugs on patients, so I knew from early on that Diovan and the same class of drugs called ARB wouldn’t work, especially for elderly patients,” Kuwajima recalled in a recent interview at Tokyo Metropolitan Geriatric Hospital, where he has retired from full-time practice but still sees patients two days a week. “I had a strong sense of crisis that hordes of elderly people — whose ranks were growing as the population grayed — would be prescribed a drug that didn’t work.”

Kuwajima said he immediately found the Diovan research suspicious because the results were just too good to be true. This was before Novartis admitted that it had paid five professors conducting studies at their universities a total of ¥1.1 billion in “research grants,” and even had Shirahashi, a Novartis employee purporting to be a university lecturer, help with statistical analyses for the papers.

The article is here.

Friday, December 1, 2017

The Essence of the Individual: The Pervasive Belief in the True Self Is an Instance of Psychological Essentialism

Andrew G. Christy, Rebecca J. Schlegel, and Andrei Cimpian
Preprint

Abstract

Eight studies (N = 2,974) were conducted to test the hypothesis that the widespread folk belief in the true self is an instance of psychological essentialism. Results supported this hypothesis. Specifically, participants’ reasoning about the true self displayed the telltale features of essentialist reasoning (immutability, discreteness, consistency, informativeness, inherence, and biological basis; Studies 1–4); participants’ endorsement of true-self beliefs correlated with individual differences in other essentialist beliefs (Study 5); and experimental manipulations of essentialist thought in domains other than the self were found to “spill over” and affect the extent to which participants endorsed true-self beliefs (Studies 6–8). These findings advance theory on the origins and functions of true-self beliefs, revealing these beliefs to be a specific instance of a broader tendency to explain phenomena in the world in terms of underlying essences.

The preprint is here.

Selling Bad Therapy to Trauma Victims

Jonathan Shedler
Psychology Today
Originally published November 19, 2017

Here is the conclusion:

First, do no harm

Many health insurance companies discriminate against psychotherapy. Congress has passed laws mandating mental health “parity” (equal coverage for medical and mental health conditions) but health insurers circumvent them. This has led to class action lawsuits against health insurance companies, but discrimination continues.

One way that health insurers circumvent parity laws is by shunting patients to the briefest and cheapest therapies — just the kind of therapies recommended by the APA’s treatment guidelines. Another way is by making therapy so impersonal and dehumanizing that patients drop out. Health insurers do not publicly say the treatment decisions are driven by economic self-interest. They say the treatments are scientifically proven — and point to treatment guidelines like those just issued by the APA.

It’s bad enough that most Americans don’t have adequate mental health coverage, without also being gaslighted and told that inadequate therapy is the best therapy.

The APA’s ethics code begins, “Psychologists strive to benefit those with whom they work and take care to do no harm.” APA has an honorable history of fighting for patients’ access to good care and against health insurance company abuses.

Blinded by RCT ideology, APA inadvertently handed a trump card to the worst apples in the health insurance industry.

The article is here.

Thursday, November 30, 2017

Artificial Intelligence & Mental Health

Smriti Joshi
Chatbot News Daily
Originally posted

Here is an excerpt:

There are many barriers to getting quality mental healthcare, from searching for a provider who practices in a user's geographical location to screening multiple potential therapists in order to find someone you feel comfortable speaking with. The stigma associated with seeking mental health treatment often leaves people silently suffering from a psychological issue. These barriers stop many people from finding help and AI is being looked at a potential tool to bridge this gap between service providers and service users.

Imagine how many people would be benefitted if artificial intelligence could bring quality and affordable mental health support to anyone with an internet connection. A psychiatrist or psychologist examines a person’s tone, word choice, and the length of a phrase etc and these are all crucial cues to understanding what’s going on in someone’s mind. Machine learning is now being applied by researchers to diagnose people with mental disorders. Harvard University and University of Vermont researchers are working on integrating machine learning tools and Instagram to improve depression screening. Using color analysis, metadata, and algorithmic face detection, they were able to reach 70 percent accuracy in detecting signs of depression. The research wing at IBM is using transcripts and audio from psychiatric interviews, coupled with machine learning techniques, to find patterns in speech to help clinicians accurately predict and monitor psychosis, schizophrenia, mania, and depression. A research, led by John Pestian, a professor at Cincinnati Children’s Hospital Medical Centre showed that machine learning is up to 93 percent accurate in identifying a suicidal person.

The post is here.

Why We Should Be Concerned About Artificial Superintelligence

Matthew Graves
Skeptic Magazine
Originally published November 2017

Here is an excerpt:

Our intelligence is ultimately a mechanistic process that happens in the brain, but there is no reason to assume that human intelligence is the only possible form of intelligence. And while the brain is complex, this is partly an artifact of the blind, incremental progress that shaped it—natural selection. This suggests that developing machine intelligence may turn out to be a simpler task than reverse- engineering the entire brain. The brain sets an upper bound on the difficulty of building machine intelligence; work to date in the field of artificial intelligence sets a lower bound; and within that range, it’s highly uncertain exactly how difficult the problem is. We could be 15 years away from the conceptual breakthroughs required, or 50 years away, or more.

The fact that artificial intelligence may be very different from human intelligence also suggests that we should be very careful about anthropomorphizing AI. Depending on the design choices AI scientists make, future AI systems may not share our goals or motivations; they may have very different concepts and intuitions; or terms like “goal” and “intuition” may not even be particularly applicable to the way AI systems think and act. AI systems may also have blind spots regarding questions that strike us as obvious. AI systems might also end up far more intelligent than any human.

The last possibility deserves special attention, since superintelligent AI has far more practical significance than other kinds of AI.

AI researchers generally agree that superintelligent AI is possible, though they have different views on how and when it’s likely to be developed. In a 2013 survey, top-cited experts in artificial intelligence assigned a median 50% probability to AI being able to “carry out most human professions at least as well as a typical human” by the year 2050, and also assigned a 50% probability to AI greatly surpassing the performance of every human in most professions within 30 years of reaching that threshold.

The article is here.

Wednesday, November 29, 2017

The Hype of Virtual Medicine

Ezekiel J. Emanuel
The Wall Street Journal
Originally posted Nov. 10, 2017

Here is an excerpt:

But none of this will have much of an effect on the big and unsolved challenge for American medicine: how to change the behavior of patients. According to the Centers for Disease Control and Prevention, fully 86% of all health care spending in the U.S. is for patients with chronic illness—emphysema, arthritis and the like. How are we to make real inroads against these problems? Patients must do far more to monitor their diseases, take their medications consistently and engage with their primary-care physicians and nurses. In the longer term, we need to lower the number of Americans who suffer from these diseases by getting them to change their habits and eat healthier diets, exercise more and avoid smoking.

There is no reason to think that virtual medicine will succeed in inducing most patients to cooperate more with their own care, no matter how ingenious the latest gizmos. Many studies that have tried some high-tech intervention to improve patients’ health have failed.

Consider the problem of patients who do not take their medication properly, leading to higher rates of complications, hospitalization and even mortality. Researchers at Harvard, in collaboration with CVS, published a study in JAMA Internal Medicine in May comparing different low-cost devices for encouraging patients to take their medication as prescribed. The more than 50,000 participants were randomly assigned to one of three options: high-tech pill bottles with digital timer caps, pillboxes with daily compartments or standard plastic pillboxes. The high-tech pill bottles did nothing to increase compliance.

Other efforts have produced similar failures.

The article is here.

A Lost World

Michael Sacasas
thefrailestthing.com
Originally posted January 29, 2017

Here is the conclusion:

Rather, it is a situation in which moral evaluations themselves have shifted. It is not that some people now lied and called an act of thoughtless aggression a courageous act. It is that what had before been commonly judged to be an act of thoughtless aggression was now judged by some to be a courageous act. In other words, it would appear that in very short order, moral judgments and the moral vocabulary in which they were expressed shifted dramatically.

It brings to mind Hannah Arendt’s frequent observation about how quickly the self-evidence of long-standing moral principles were overturned in Nazi Germany: “… it was as though morality suddenly stood revealed in the original meaning of the word, as a set of mores, customs and manners, which could be exchanged for another set with hardly more trouble than it would take to change the table manners of an individual or a people.”

It is shortsighted, at this juncture, to ask how we can find agreement or even compromise. We do not, now, even know how to disagree well; nothing like an argument in the traditional sense is being had. It is an open question whether anyone can even be said to be speaking intelligibly to anyone who does not already fully agree with their positions and premises. The common world that is both the condition of speech and its gift to us is withering away. A rift has opened up in our political culture that will not be mended until we figure out how to reconstruct the conditions under which speech can once again become meaningful. Until then, I fear, the worst is still before us.

The post is here.