Ananda R. Ganguly and Joshua Tasoff
Management Science
Last revised: 1 Jun 2016
Abstract
We present evidence that intrinsic demand for information about the future is increasing in expected future consumption utility. In the first experiment, subjects may resolve a lottery now or later. The information is useless for decision making but the larger the reward, the more likely subjects are to pay to resolve the lottery early. In the second experiment subjects may pay to avoid being tested for HSV-1 and the more highly feared HSV-2. Subjects are three times more likely to avoid testing for HSV-2, suggesting that more aversive outcomes lead to more information avoidance. In a third experiment, subjects make choices about when to get tested for a fictional disease. Some subjects behave in a way consistent with expected utility theory and others exhibit greater delay of information for more severe diseases. We also find that information choice is correlated with positive affect, ambiguity aversion, and time preference as some theories predict.
The research is here.
Saturday, February 17, 2018
Friday, February 16, 2018
The Scientism of Psychiatry
Sami Timimi
Mad in America
Originally posted January 10, 2018
Here is an excerpt:
Mainstream psychiatry has been afflicted by at least two types of scientism. Firstly, it parodies science as ideology, liking to talk in scientific language, using the language of EBM, and carrying out research that ‘looks’ scientific (such as brain scanning). Psychiatry wants to be seen as residing in the same scientific cosmology as the rest of medicine. Yet the cupboard of actual clinically relevant findings remains pretty empty. Secondly, it ignores much of the genuine science there is and goes on supporting and perpetuating concepts and treatments that have little scientific support. This is a more harmful and deceptive form of scientism; it means that psychiatry likes to talk in the language of science and treats this as more important than the actual science.
I have had debates with fellow psychiatrists on many aspects of the actual evidence base. Two ‘defences’ have become familiar to me. The first is use of anecdote — such and such a patient got better with such and such a treatment, therefore, this treatment ‘works.’ Anecdote is precisely what EBM was trying to get away from. The second is an appeal for me to take a ‘balanced’ perspective. Of course each person’s idea of what is a ‘balanced’ position depends on where they are sitting. We get our ideas on what is ‘balanced’ from what is culturally dominant, not from what the science is telling us. At one point, to many people, Nelson Mandala was a violent terrorist; later to many more people, he becomes the embodiment of peaceful reconciliation and forgiveness. What were considered ‘balanced’ views on him were almost polar opposites, depending on where and when you were examining him from. Furthermore, in science facts are simply that. Our interpretations are of course based on our reading of these facts. Providing an interpretation consistent with the facts is more important than any one person’s notion of what a ‘balanced’ position should look like.
The article is here.
Mad in America
Originally posted January 10, 2018
Here is an excerpt:
Mainstream psychiatry has been afflicted by at least two types of scientism. Firstly, it parodies science as ideology, liking to talk in scientific language, using the language of EBM, and carrying out research that ‘looks’ scientific (such as brain scanning). Psychiatry wants to be seen as residing in the same scientific cosmology as the rest of medicine. Yet the cupboard of actual clinically relevant findings remains pretty empty. Secondly, it ignores much of the genuine science there is and goes on supporting and perpetuating concepts and treatments that have little scientific support. This is a more harmful and deceptive form of scientism; it means that psychiatry likes to talk in the language of science and treats this as more important than the actual science.
I have had debates with fellow psychiatrists on many aspects of the actual evidence base. Two ‘defences’ have become familiar to me. The first is use of anecdote — such and such a patient got better with such and such a treatment, therefore, this treatment ‘works.’ Anecdote is precisely what EBM was trying to get away from. The second is an appeal for me to take a ‘balanced’ perspective. Of course each person’s idea of what is a ‘balanced’ position depends on where they are sitting. We get our ideas on what is ‘balanced’ from what is culturally dominant, not from what the science is telling us. At one point, to many people, Nelson Mandala was a violent terrorist; later to many more people, he becomes the embodiment of peaceful reconciliation and forgiveness. What were considered ‘balanced’ views on him were almost polar opposites, depending on where and when you were examining him from. Furthermore, in science facts are simply that. Our interpretations are of course based on our reading of these facts. Providing an interpretation consistent with the facts is more important than any one person’s notion of what a ‘balanced’ position should look like.
The article is here.
Health Care Workers & Moral Objections I: Procedures
Mike LaBossiere
Talking Philosophy
Originally published on January 18, 2018
Here is an excerpt:
But, this moral coin has another side—entering a profession, especially in the field of health, also comes with moral and professional responsibilities. These responsibilities can, like all responsibilities, can justly impose burdens. For example, doctors are not permitted to instantly abandon patients they dislike or because they want to move to a better paying position. As such, ethics of a health worker refusing to perform a procedure based on their moral or religious views requires that each procedure be reviewed to determine whether it is one that a health care worker can justly refuse or one that is a justly imposed burden.
To illustrate, consider a doctor who is asked to keep prisoners conscious and alive during torture performed by agents of the state. Most doctors, like most people, would have moral objections to being involved in torture. However, there is the question of whether this would be something they should be morally expected to do as part of their profession. On the face of it, since the purpose of the medical profession is to heal and alleviate suffering (a professional ethics that goes back to the origin of western medicine) this is not something that a doctor is obligated to do even in the face of moral objections. In fact, the ethics of the profession would dictate against engaging in this behavior.
Now, imagine a health care worker who has sincere religious or moral beliefs that when a person can no longer sustain their life on their own, they must be released to God. As such, the worker refuses to engage in procedures that violate their principles, such as keeping a patient on life support. While this could be a sincerely held belief, it seems to run counter to the ethics of the profession. As such, such a health care worker would seem to not have the right to refuse such services.
The article is here.
Talking Philosophy
Originally published on January 18, 2018
Here is an excerpt:
But, this moral coin has another side—entering a profession, especially in the field of health, also comes with moral and professional responsibilities. These responsibilities can, like all responsibilities, can justly impose burdens. For example, doctors are not permitted to instantly abandon patients they dislike or because they want to move to a better paying position. As such, ethics of a health worker refusing to perform a procedure based on their moral or religious views requires that each procedure be reviewed to determine whether it is one that a health care worker can justly refuse or one that is a justly imposed burden.
To illustrate, consider a doctor who is asked to keep prisoners conscious and alive during torture performed by agents of the state. Most doctors, like most people, would have moral objections to being involved in torture. However, there is the question of whether this would be something they should be morally expected to do as part of their profession. On the face of it, since the purpose of the medical profession is to heal and alleviate suffering (a professional ethics that goes back to the origin of western medicine) this is not something that a doctor is obligated to do even in the face of moral objections. In fact, the ethics of the profession would dictate against engaging in this behavior.
Now, imagine a health care worker who has sincere religious or moral beliefs that when a person can no longer sustain their life on their own, they must be released to God. As such, the worker refuses to engage in procedures that violate their principles, such as keeping a patient on life support. While this could be a sincerely held belief, it seems to run counter to the ethics of the profession. As such, such a health care worker would seem to not have the right to refuse such services.
The article is here.
Thursday, February 15, 2018
Declining Trust in Facts, Institutions Imposes Real-World Costs on U.S. Society
Rand Corporation
Pressor
Released on January 16, 2018
Americans' reliance on facts to discuss public issues has declined significantly in the past two decades, leading to political paralysis and collapse of civil discourse, according to a RAND Corporation report.
This phenomenon, referred to as “Truth Decay,” is defined by increasing disagreement about facts, a blurring between opinion and fact, an increase in the relative volume of opinion and personal experience over fact, and declining trust in formerly respected sources of factual information.
While there is evidence of similar phenomena in earlier eras in U.S. history, the current manifestation of Truth Decay is exacerbated by changes in the ways Americans consume information—particularly via social media and cable news. Other influences that may make Truth Decay more intense today include political, economic and social polarization that segment and divide the citizenry, the study finds.
These factors lead to Truth Decay's damaging consequences, such as political paralysis and uncertainty in national policy, which incur real costs. The government shutdown of 2013, which lasted 16 days, resulted in a $20 billion loss to the U.S. economy, according to estimates cited in the study.
The pressor is here.
Pressor
Released on January 16, 2018
Americans' reliance on facts to discuss public issues has declined significantly in the past two decades, leading to political paralysis and collapse of civil discourse, according to a RAND Corporation report.
This phenomenon, referred to as “Truth Decay,” is defined by increasing disagreement about facts, a blurring between opinion and fact, an increase in the relative volume of opinion and personal experience over fact, and declining trust in formerly respected sources of factual information.
While there is evidence of similar phenomena in earlier eras in U.S. history, the current manifestation of Truth Decay is exacerbated by changes in the ways Americans consume information—particularly via social media and cable news. Other influences that may make Truth Decay more intense today include political, economic and social polarization that segment and divide the citizenry, the study finds.
These factors lead to Truth Decay's damaging consequences, such as political paralysis and uncertainty in national policy, which incur real costs. The government shutdown of 2013, which lasted 16 days, resulted in a $20 billion loss to the U.S. economy, according to estimates cited in the study.
The pressor is here.
Engineers, philosophers and sociologists release ethical design guidelines for future technology
Rafael A Calvo and Dorian Peters
The Conversation
Originally posted December 12, 2017
Here is an excerpt:
The big questions posed by our digital future sit at the intersection of technology and ethics. This is complex territory that requires input from experts in many different fields if we are to navigate it successfully.
To prepare the report, economists and sociologists researched the effect of technology on disempowered groups. Lawyers considered the future of privacy and justice. Doctors and psychologists examined impacts on physical and mental health. Philosophers unpacked hidden biases and moral questions.
The report suggests all technologies should be guided by five general principles:
Sticky questions
The report runs the spectrum from practical to more abstract concerns, touching on personal data ownership, autonomous weapons, job displacement and questions like “can decisions made by amoral systems have moral consequences?”
One section deals with a “lack of ownership or responsibility from the tech community”. It points to a divide between how the technology community sees its ethical responsibilities and the broader social concerns raised by public, legal, and professional communities.
The article is here.
The Conversation
Originally posted December 12, 2017
Here is an excerpt:
The big questions posed by our digital future sit at the intersection of technology and ethics. This is complex territory that requires input from experts in many different fields if we are to navigate it successfully.
To prepare the report, economists and sociologists researched the effect of technology on disempowered groups. Lawyers considered the future of privacy and justice. Doctors and psychologists examined impacts on physical and mental health. Philosophers unpacked hidden biases and moral questions.
The report suggests all technologies should be guided by five general principles:
- protecting human rights
- prioritising and employing established metrics for measuring wellbeing
- ensuring designers and operators of new technologies are accountable
- making processes transparent
- minimizing the risks of misuse.
Sticky questions
The report runs the spectrum from practical to more abstract concerns, touching on personal data ownership, autonomous weapons, job displacement and questions like “can decisions made by amoral systems have moral consequences?”
One section deals with a “lack of ownership or responsibility from the tech community”. It points to a divide between how the technology community sees its ethical responsibilities and the broader social concerns raised by public, legal, and professional communities.
The article is here.
Wednesday, February 14, 2018
Alone Together: Who's Lonely and How Do We Measure It?
Tom Harrison
The RSA.org
Originally published January 18, 2018
Here is an excerpt:
What affect does loneliness have on our health?
Neuroscientist John Cacioppo’s seminal work published in ‘Loneliness: Human Nature and Need for Social Connection’ was one of the first to study the health impacts of loneliness. He found that lonely people have a 20 per cent higher premature mortality rate and called for a culture shift that would see loneliness as important a public health issue as obesity. The Campaign to End Loneliness acknowledges this; reporting that 3 out of 4 GPs say they see between 1 and 5 people a day who have come in mainly because they are lonely.
Indeed, research tells us that this phenomenon goes far beyond the familiar stereotype of an isolated grandmother. A recent British Red Cross report found that 32 per cent of those aged 16-24 reported that in the past 2 weeks they had often or always felt lonely. Are 1/3 of young people just snowflakes? It seems unlikely.
This has contributed to pressure for government to respond. But how do we measure the problem and what are responses required to tackle it?
The article is here.
Note to Reader: Psychotherapy can help with loneliness.
The RSA.org
Originally published January 18, 2018
Here is an excerpt:
What affect does loneliness have on our health?
Neuroscientist John Cacioppo’s seminal work published in ‘Loneliness: Human Nature and Need for Social Connection’ was one of the first to study the health impacts of loneliness. He found that lonely people have a 20 per cent higher premature mortality rate and called for a culture shift that would see loneliness as important a public health issue as obesity. The Campaign to End Loneliness acknowledges this; reporting that 3 out of 4 GPs say they see between 1 and 5 people a day who have come in mainly because they are lonely.
Indeed, research tells us that this phenomenon goes far beyond the familiar stereotype of an isolated grandmother. A recent British Red Cross report found that 32 per cent of those aged 16-24 reported that in the past 2 weeks they had often or always felt lonely. Are 1/3 of young people just snowflakes? It seems unlikely.
This has contributed to pressure for government to respond. But how do we measure the problem and what are responses required to tackle it?
The article is here.
Note to Reader: Psychotherapy can help with loneliness.
Tuesday, February 13, 2018
How Should Physicians Make Decisions about Mandatory Reporting When a Patient Might Become Violent?
Amy Barnhorst, Garen Wintemute, and Marian Betz
AMA Journal of Ethics. January 2018, Volume 20, Number 1: 29-35.
Abstract
Mandatory reporting of persons believed to be at imminent risk for committing violence or attempting suicide can pose an ethical dilemma for physicians, who might find themselves struggling to balance various conflicting interests. Legal statutes dictate general scenarios that require mandatory reporting to supersede confidentiality requirements, but physicians must use clinical judgment to determine whether and when a particular case meets the requirement. In situations in which it is not clear whether reporting is legally required, the situation should be analyzed for its benefit to the patient and to public safety. Access to firearms can complicate these situations, as firearms are a well-established risk factor for violence and suicide yet also a sensitive topic about which physicians and patients might have strong personal beliefs.
The commentary is here.
AMA Journal of Ethics. January 2018, Volume 20, Number 1: 29-35.
Abstract
Mandatory reporting of persons believed to be at imminent risk for committing violence or attempting suicide can pose an ethical dilemma for physicians, who might find themselves struggling to balance various conflicting interests. Legal statutes dictate general scenarios that require mandatory reporting to supersede confidentiality requirements, but physicians must use clinical judgment to determine whether and when a particular case meets the requirement. In situations in which it is not clear whether reporting is legally required, the situation should be analyzed for its benefit to the patient and to public safety. Access to firearms can complicate these situations, as firearms are a well-established risk factor for violence and suicide yet also a sensitive topic about which physicians and patients might have strong personal beliefs.
The commentary is here.
Does Volk v. DeMeerleer Conflict with the AMA Code of Medical Ethics?
Jennifer L. Piel and Rejoice Opara
AMA Journal of Ethics. January 2018, Volume 20, Number 1: 10-18.
Abstract
A recent Washington State case revisits the obligation of mental health clinicians to protect third parties from the violent acts of their patients. Although the case of Volk v DeMeerleer raises multiple legal, ethical, and policy issues, this article will focus on a potential ethical conflict between the case law and professional guidelines, namely the American Medical Association’s Code of Medical Ethics.
Here is a portion of the conclusion:
The Volk case established legal precedent for outpatient mental health clinicians in Washington State. Future cases against clinicians for their patients’ harm to third parties (e.g., medical negligence, wrongful death) will be tried under the Volk standard. It will be up to the trier of fact to determine whether the victims of a patient’s violence were foreseeable and, if so, whether the clinician acted reasonably to protect them.
Without changes to this law, there is increased likelihood that future clinicians and employers in similar situations, fearful of being in Dr. Ashby’s position, will more willingly (and likely unhelpfully) breach patient confidentiality. This creates a dilemma for clinicians in Washington State, who could find themselves caught between trying to meet the requirements of the legal case and also adhering to their professional ethical guidelines.
The article is here.
AMA Journal of Ethics. January 2018, Volume 20, Number 1: 10-18.
Abstract
A recent Washington State case revisits the obligation of mental health clinicians to protect third parties from the violent acts of their patients. Although the case of Volk v DeMeerleer raises multiple legal, ethical, and policy issues, this article will focus on a potential ethical conflict between the case law and professional guidelines, namely the American Medical Association’s Code of Medical Ethics.
Here is a portion of the conclusion:
The Volk case established legal precedent for outpatient mental health clinicians in Washington State. Future cases against clinicians for their patients’ harm to third parties (e.g., medical negligence, wrongful death) will be tried under the Volk standard. It will be up to the trier of fact to determine whether the victims of a patient’s violence were foreseeable and, if so, whether the clinician acted reasonably to protect them.
Without changes to this law, there is increased likelihood that future clinicians and employers in similar situations, fearful of being in Dr. Ashby’s position, will more willingly (and likely unhelpfully) breach patient confidentiality. This creates a dilemma for clinicians in Washington State, who could find themselves caught between trying to meet the requirements of the legal case and also adhering to their professional ethical guidelines.
The article is here.
Monday, February 12, 2018
Prison for psychologist had sex with patients
Perrin Stein
Gillette News Record
Originally published January 12, 2018
It was standing room only in the courtroom as dozens of people gathered Thursday afternoon to see a former Gillette psychologist sentenced to prison for sexually assaulting two patients.
“During my brief time as a therapist, I did more harm than good and acted in ways that will reverberate in these women’s lives for years to come,” Joshua Popkin, 33, said before being taken into custody to serve two consecutive three- to five-year prison sentences for two counts of second-degree sexual assault.
Popkin met the two patients while interning at Campbell County Health in 2015.
One of the patients was seeking treatment for mental health issues related to a previous rape by an assailant elsewhere, according to court documents. After treating her at CCH, he saw her at his private practice, where he made increasingly sexual advances toward her. In June 2016, he had forced sex with her, according to court documents.
The article is here.
Gillette News Record
Originally published January 12, 2018
It was standing room only in the courtroom as dozens of people gathered Thursday afternoon to see a former Gillette psychologist sentenced to prison for sexually assaulting two patients.
“During my brief time as a therapist, I did more harm than good and acted in ways that will reverberate in these women’s lives for years to come,” Joshua Popkin, 33, said before being taken into custody to serve two consecutive three- to five-year prison sentences for two counts of second-degree sexual assault.
Popkin met the two patients while interning at Campbell County Health in 2015.
One of the patients was seeking treatment for mental health issues related to a previous rape by an assailant elsewhere, according to court documents. After treating her at CCH, he saw her at his private practice, where he made increasingly sexual advances toward her. In June 2016, he had forced sex with her, according to court documents.
The article is here.
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