Illegal VA policy allows hiring since 2002 of medical workers with revoked licenses

Donovan Slack
USA Today
Originally published December 21, 2017

The Department of Veterans Affairs has allowed its hospitals across the country to hire health care providers with revoked medical licenses for at least 15 years in violation of federal law, a USA TODAY investigation found.

The VA issued national guidelines in 2002 giving local hospitals discretion to hire clinicians after “prior consideration of all relevant facts surrounding” any revocations and as long as they still had a license in one state.

But a federal law passed in 1999 bars the VA from employing any health care worker whose license has been yanked by any state.

Hospital officials at the VA in Iowa City relied on the illegal guidance earlier this year to hire neurosurgeon John Henry Schneider, who had revealed in his application that he had numerous malpractice claims and settlements and Wyoming had revoked his license after a patient death. He still had a license in Montana.

The article is here.

The neuroscience of morality and social decision-making

Keith Yoder and Jean Decety
Psychology, Crime & Law
doi: 10.1080/1068316X.2017.1414817

Abstract
Across cultures humans care deeply about morality and create institutions, such as criminal courts, to enforce social norms. In such contexts, judges and juries engage in complex social decision-making to ascertain a defendant’s capacity, blameworthiness, and culpability. Cognitive neuroscience investigations have begun to reveal the distributed neural networks which interact to implement moral judgment and social decision-making, including systems for reward learning, valuation, mental state understanding, and salience processing. These processes are fundamental to morality, and their underlying neural mechanisms are influenced by individual differences in empathy, caring and justice sensitivity. This new knowledge has important implication in legal settings for understanding how triers of fact reason. Moreover, recent work demonstrates how disruptions within the social decision-making network facilitate immoral behavior, as in the case of psychopathy. Incorporating neuroscientific methods with psychology and clinical neuroscience has the potential to improve predictions of recidivism, future dangerousness, and responsivity to particular forms of rehabilitation.

The article is here.

From the Conclusion section:

Current neuroscience work demonstrates that social decision-making and moral reasoning rely on multiple partially overlapping neural networks which support domain general processes, such as executive control, saliency processing, perspective-taking, reasoning, and valuation. Neuroscience investigations have contributed to a growing understanding of the role of these process in moral cognition and judgments of blame and culpability, exactly the sorts of judgments required of judges and juries. Dysfunction of these networks can lead to dysfunctional social behavior and a propensity to immoral behavior as in the case of psychopathy. Significant progress has been made in clarifying which aspects of social decision-making network functioning are most predictive of future recidivism. Psychopathy, in particular, constitutes a complex type of moral disorder and a challenge to the criminal justice system.

Worth reading.....

The Neuroscience of Changing Your Mind

 Bret Stetka
Scientific American
Originally published on December 7, 2017

Here are two excerpts:

Scientists have long accepted that our ability to abruptly stop or modify a planned behavior is controlled via a single region within the brain’s prefrontal cortex, an area involved in planning and other higher mental functions. By studying other parts of the brain in both humans and monkeys, however, a team from Johns Hopkins University has now concluded that last-minute decision-making is a lot more complicated than previously known, involving complex neural coordination among multiple brain areas. The revelations may help scientists unravel certain aspects of addictive behaviors and understand why accidents like falls grow increasingly common as we age, according to the Johns Hopkins team.

(cut)

Tracking these eye movements and neural action let the researchers resolve the very confusing question of what brain areas are involved in these split-second decisions, says Vanderbilt University neuroscientist Jeffrey Schall, who was not involved in the research. “By combining human functional brain imaging with nonhuman primate neurophysiology, [the investigators] weave together threads of research that have too long been separate strands,” he says. “If we can understand how the brain stops or prevents an action, we may gain ability to enhance that stopping process to afford individuals more control over their choices.”

The article is here.

Votes for the future

Thomas Wells
Aeon.co
Originally published May 8, 2014

Here is an excerpt:

By contrast, future generations must accept whatever we choose to bequeath them, and they have no way of informing us of their values. In this, they are even more helpless than foreigners, on whom our political decisions about pollution, trade, war and so on are similarly imposed without consent. Disenfranchised as they are, such foreigners can at least petition their own governments to tell ours off, or engage with us directly by writing articles in our newspapers about the justice of their cause. The citizens of the future lack even this recourse.

The asymmetry between past and future is more than unfair. Our ancestors are beyond harm; they cannot know if we disappoint them. Yet the political decisions we make today will do more than just determine the burdens of citizenship for our grandchildren. They also concern existential dangers such as the likelihood of pandemics and environmental collapse. Without a presence in our political system, the plight of future citizens who might suffer or gain from our present political decisions cannot be properly weighed. We need to give them a voice.

How could we do that? After all, they can’t actually speak to us. Yet even if we can’t know what future citizens will actually value and believe in, we can still consider their interests, on the reasonable assumption that they will somewhat resemble our own (everybody needs breathable air, for example). Interests are much easier than wishes, and quite suitable for representation by proxies.

So perhaps we should simply encourage current citizens to take up the Burkean perspective and think of their civic duty in a more extended way when casting votes. Could this work?

The article is here.

Leaders Don't Make Deals About Ethics

John Baldoni
Forbes.com
Originally published December 8, 2017

Here is an excerpt:

Partisanship abides in darker recesses of our human nature; it’s about winning at all costs. Partisans comfort themselves that their side is in the right, and therefore, whatever they do to promote it is correct. To them I quote Abraham Lincoln: “my concern is not whether God is on our side; my greatest concern is to be on God's side, for God is always right."

Human values do not need to be sanctioned through religious faith. Human values as they relate to morality, equality and dignity are bedrock principles that when cast aside allow aberrant and abhorrent behaviors to flourish. The least among us become the most preyed-upon among us.

Ethics therefore knows no party. The Me Too movement is apolitical; it gives voice to women who have been abused. The preyed upon are beginning to take back what they never should have lost in the first place – their dignity. To argue about which party – or which industry – has the most sexual harassers is a fool’s errand. Sexual harassers exist within every social strata as well as every political persuasion.

Living by a moral code is putting into practice what you believe is right. That is, you call out men who abuse women – as well as all those who give the abusers sanctuary. Right now, men in powerful positions in the media, business and politics are tumbling like dominoes.

But make no mistake — there are bosses in organizations of every kind who are guilty of sexual harassment and worse. A moral code demands that such men be exposed for their predatory behaviors. It also demands protection for their accusers.

The article is here.

What I Was Wrong About This Year

David Leonhardt
The New York Times
Originally posted December 24, 2017

Here is an excerpt:

But I’ve come to realize that I was wrong about a major aspect of probabilities.

They are inherently hard to grasp. That’s especially true for an individual event, like a war or election. People understand that if they roll a die 100 times, they will get some 1’s. But when they see a probability for one event, they tend to think: Is this going to happen or not?

They then effectively round to 0 or to 100 percent. That’s what the Israeli official did. It’s also what many Americans did when they heard Hillary Clinton had a 72 percent or 85 percent chance of winning. It’s what football fans did in the Super Bowl when the Atlanta Falcons had a 99 percent chance of victory.

And when the unlikely happens, people scream: The probabilities were wrong!

Usually, they were not wrong. The screamers were wrong.

The article is here.

VA knowingly hires doctors with past malpractice claims, discipline for poor care

Donovan Slack
USA Today
Originally published December 3, 2017

Here is an excerpt:

A VA hospital in Oklahoma knowingly hired a psychiatrist previously sanctioned for sexual misconduct who went on to sleep with a VA patient, according to internal documents. A Louisiana VA clinic hired a psychologist with felony convictions. The VA ended up firing him after they determined he was a “direct threat to others” and the VA’s mission.

As a result of USA TODAY’s investigation of Schneider, VA officials determined his hiring — and potentially that of an unknown number of other doctors — was illegal.

Federal law bars the agency from hiring physicians whose license has been revoked by a state board, even if they still hold an active license in another state. Schneider still has a license in Montana, even though his Wyoming license was revoked.

VA spokesman Curt Cashour said agency officials provided hospital officials in Iowa City with “incorrect guidance” green-lighting Schneider’s hire. The VA moved to fire Schneider last Wednesday. He resigned instead.

The article is here.

Are There Non-human Persons? Are There Non-person Humans?

Glenn Cohen | TEDxCambridge
Published October 24, 2017



If we want to live a moral life, how should we treat animals or complex artificial intelligence? What kinds of rights should non-humans have? Harvard Law Professor and world-renowned bioethics expert Glenn Cohen shares how our current moral vocabulary may be leading us into fundamental errors and how to face the complex moral world around us. Glenn Cohen is one of the world’s leading experts on the intersection of bioethics and the law, as well as health law. He is an award-winning speaker and writer having authored more than 98 articles and chapters appearing in countless journals and gaining coverage on ABC, CNN, MSNBC, PBS, the New York Times and more. He recently finished his role as one of the project leads on the multi-million dollar Football Players Health Study at Harvard aimed at improving NFL player health.

Freud in the scanner

M. M. Owen
aeon.co
Originally published December 7, 2017

Here is an excerpt:

This is why Freud is less important to the field than what Freud represents. Researching this piece, I kept wondering: why hang on to Freud? He is an intensely polarising figure, so polarising that through the 1980s and ’90s there raged the so-called Freud Wars, fighting on one side of which were a whole team of authors driven (as the historian of science John Forrester put it in 1997) by the ‘heartfelt wish that Freud might never have been born or, failing to achieve that end, that all his works and influence be made as nothing’. Indeed, a basic inability to track down anyone with a dispassionate take on psychoanalysis was a frustration of researching this essay. The certitude that whatever I write here will enrage some readers hovers at the back of my mind as I think ahead to skimming the comments section. Preserve subjectivity, I thought, fine, I’m onboard. But why not eschew the heavily contested Freudianism for the psychotherapy of Irvin D Yalom, which takes an existentialist view of the basic challenges of life? Why not embrace Viktor Frankl’s logotherapy, which prioritises our fundamental desire to give life meaning, or the philosophical tradition of phenomenology, whose first principle is that subjectivity precedes all else?

Within neuropsychoanalysis, though, Freud symbolises the fact that, to quote the neuroscientist Ramachandran’s Phantoms in the Brain (1998), you can ‘look for laws of mental life in much the same way that a cardiologist might study the heart or an astronomer study planetary motion’. And on the clinical side, it is simply a fact that before Freud there was really no such thing as therapy, as we understand that word today. In Yalom’s novel When Nietzsche Wept (1992), Josef Breuer, Freud’s mentor, is at a loss for how to counsel the titular German philosopher out of his despair: ‘There is no medicine for despair, no doctor for the soul,’ he says. All Breuer can recommend are therapeutic spas, ‘or perhaps a talk with a priest’.

The article is here.