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

Sunday, September 16, 2018

Time to abandon grand ethical theories?

Julian Baggini
TheTLS.co
Originally posted May 22, 2018

Here are two excerpts:

Social psychologists, sociologists and anthropologists would not be baffled by this apparent contradiction. Many have long believed that morality is essentially a system of social regulation. As such it is in no more need of a divine foundation or a philosophical justification than folk dancing or tribal loyalty. Indeed, if ethics is just the management of the social sphere, it should not be surprising that as we live in a more globalized world, ethics becomes enlarged to encompass not only how we treat kith and kin but our distant neighbours too.

Philosophers have more to worry about. They are not generally satisfied to see morality as a purely pragmatic means of keeping the peace. To see the world muddling through morality is deeply troubling. Where’s the consistency? Where’s the theoretical framework? Where’s the argument?

(cut)

There is then a curious combination of incoherence and vagueness about just what it is to be ethical, and a bogus precision in the ways in which organizations prove themselves to be good. All this confusion helps fuel philosophical ethics, which has become a vibrant, thriving discipline, providing academic presses with a steady stream of books. Looking over a sample of their recent output, it is evident that moral philosophers are keen to show that they are not just playing intellectual games and that they have something to offer the world.

The info is here.

Saturday, September 15, 2018

Social Science One And How Top Journals View The Ethics Of Facebook Data Research

Kalev Leetaru
Forbes.com
Originally posted on August 13, 2018

Here is an excerpt:

At the same time, Social Science One’s decision to leave all ethical questions TBD and to eliminate the right to informed consent or the ability to opt out of research fundamentally redefines what it means to conduct research in the digital era, normalizing the removal of these once sacred ethical tenets. Given the refusal of one of its committee members to provide replication data for his own study and the statement by another committee member that “I have articulated the argument that ToS are not, and should not be considered, ironclad rules binding the activities of academic researchers. … I don't think researchers should reasonably be expected to adhere to such conditions, especially at a time when officially sanctioned options for collecting social media data are disappearing left and right,” the result is an ethically murky landscape in which it is unclear just where Social Science One draws the line at what it will or will not permit.

Given Facebook’s new focus on “privacy first” I asked the company whether it would commit to offering its two billion users a new profile setting allowing them to opt out of having their data made available to academic researchers such as Social Science One. As it has repeatedly done in the past, the company declined to comment.

The info is here.

Friday, September 14, 2018

Law, Ethics, and Conversations between Physicians and Patients about Firearms in the Home

Alexander D. McCourt, and Jon S. Vernick
AMA J Ethics. 2018;20(1):69-76.

Abstract

Firearms in the home pose a risk to household members, including homicide, suicide, and unintentional deaths. Medical societies urge clinicians to counsel patients about those risks as part of sound medical practice. Depending on the circumstances, clinicians might recommend safe firearm storage, temporary removal of the firearm from the home, or other measures. Certain state firearm laws, however, might present legal and ethical challenges for physicians who counsel patients about guns in the home. Specifically, we discuss state background check laws for gun transfers, safe gun storage laws, and laws forbidding physicians from engaging in certain firearm-related conversations with their patients. Medical professionals should be aware of these and other state gun laws but should offer anticipatory guidance when clinically appropriate.

The info is here.

What Are “Ethics in Design”?

Victoria Sgarro
slate.com
Originally posted August 13, 2018

Here is an excerpt:

As a product designer, I know that no mandate exists to integrate these ethical checks and balances in our process. While I may hear a lot of these issues raised at speaking events and industry meetups, more “practical” considerations can overshadow these conversations in my day-to-day decision making. When they have to compete with the workaday pressures of budgets, roadmaps, and clients, these questions won’t emerge as priorities organically.

Most important, then, is action. Castillo worries that the conversation about “ethics in design” could become a cliché, like “empathy” or “diversity” in tech, where it’s more talk than walk. She says it’s not surprising that ethics in tech hasn’t been addressed in depth in the past, given the industry’s lack of diversity. Because most tech employees come from socially privileged backgrounds, they may not be as attuned to ethical concerns. A designer who identifies with society’s dominant culture may have less personal need to take another perspective. Indeed, identification with a society’s majority is shown to be correlated with less critical awareness of the world outside of yourself. Castillo says that, as a black woman in America, she’s a bit wary of this conversation’s effectiveness if it remains only a conversation.

“You know how someone says, ‘Why’d you become a nurse or doctor?’ And they say, ‘I want to help people’?” asks Castillo. “Wouldn’t it be cool if someone says, ‘Why’d you become an engineer or a product designer?’ And you say, ‘I want to help people.’ ”

The info is here.

Thursday, September 13, 2018

How Should Clinicians Respond to Requests from Patients to Participate in Prayer?

A. R. Christensen, T. E. Cook, and R. M. Arnold
AMA J Ethics. 2018;20(7):E621-629.

Abstract

Over the past 20 years, physicians have shifted from viewing a patient’s request for prayer as a violation of professional boundaries to a question deserving nuanced understanding of the patient’s needs and the clinician’s boundaries. In this case, Mrs. C’s request for prayer can reflect religious distress, anxiety about her clinical circumstances, or a desire to better connect with her physician. These different needs suggest that it is important to understand the request before responding. To do this well requires that Dr. Q not be emotionally overwhelmed by the request and that she has skill in discerning potential reasons for the request.

The info is here.

Meet the Chatbots Providing Mental Health Care

Daniela Hernandez
Wall Street Journal
Originally published Aug. 9, 2018

Here is an excerpt:

Wysa Ltd., a London- and Bangalore-based startup, is testing a free chatbot to teach adolescents emotional resilience, said co-founder Ramakant Vempati.  In the app, a chubby penguin named Wysa helps users evaluate the sources of their stress and provides tips on how to stay positive, like thinking of a loved one or spending time outside.  The company said its 400,000 users, most of whom are under 35, have had more than 20 million conversations with the bot.

Wysa is a wellness app, not a medical intervention, Vempati said, but it relies on cognitive behavioral therapy, mindfulness techniques and meditations that are “known to work in a self-help context.”  If a user expresses thoughts of self-harm, Wysa reminds them that it’s just a bot and provides contact information for crisis hotlines.  Alternatively, for $30 a month, users can access unlimited chat sessions with a human “coach.”  Other therapy apps, such as Talkspace, offer similar low-cost services with licensed professionals.

Chatbots have potential, said Beth Jaworski, a mobile apps specialist at the National Center for PTSD in Menlo Park, Calif.  But definitive research on whether they can help patients with more serious conditions, like major depression, still hasn’t been done, in part because the technology is so new, she said.  Clinicians also worry about privacy.  Mental health information is sensitive data; turning it over to companies could have unforeseen consequences.

The article is here.

Wednesday, September 12, 2018

How Could Commercial Terms of Use and Privacy Policies Undermine Informed Consent in the Age of Mobile Health?

Cynthia E. Schairer, Caryn Kseniya Rubanovich, and Cinnamon S. Bloss
AMA J Ethics. 2018;20(9):E864-872.

Abstract

Granular personal data generated by mobile health (mHealth) technologies coupled with the complexity of mHealth systems creates risks to privacy that are difficult to foresee, understand, and communicate, especially for purposes of informed consent. Moreover, commercial terms of use, to which users are almost always required to agree, depart significantly from standards of informed consent. As data use scandals increasingly surface in the news, the field of mHealth must advocate for user-centered privacy and informed consent practices that motivate patients’ and research participants’ trust. We review the challenges and relevance of informed consent and discuss opportunities for creating new standards for user-centered informed consent processes in the age of mHealth.

The info is here.

‘My death is not my own’: the limits of legal euthanasia

Henk Blanken
The Guardian
Originally posted August 10, 2018

Here is an excerpt:

Of the 10,000 Dutch patients with dementia who die each year, roughly half of them will have had an advance euthanasia directive. They believed a doctor would “help” them. After all, this was permitted by law, and it was their express wish. Their naive confidence is shared by four out of 10 Dutch adults, who are convinced that a doctor is bound by an advance directive. In fact, doctors are not obliged to do anything. Euthanasia may be legal, but it is not a right.

As doctors have a monopoly on merciful killing, their ethical standard, and not the law, ultimately determines whether a man like Joop can die. An advance directive is just one factor, among many, that a doctor will consider when deciding on a euthanasia case. And even though the law says it’s legal, almost no doctors are willing to perform euthanasia on patients with severe dementia, since such patients are no longer mentally capable of making a “well-considered request” to die.

This is the catch-22. If your dementia is at such an early stage that you are mentally fit enough to decide that you want to die, then it is probably “too early” to want to die. You still have good years left. And yet, by the time your dementia has deteriorated to the point at which you wished (when your mind was intact) to die, you will no longer be allowed to die, as you are not mentally fit to make that decision. It is now “too late” to die.

The info is here.

Tuesday, September 11, 2018

Against mourning

Brian Earp
aeon.com
Originally posted August 21, 2018

Here is an excerpt:

That is what is so different about their intuitions and ours. To put it simply, if you are not a Stoic philosopher – if you have not been training yourself, year in and year out, to calmly face life’s vagaries and inescapables – and you feel no hint of sadness when your child, or spouse, or family member dies, then there probably is something wrong with you. You probably have failed to love or cherish that person appropriately or sufficiently while they were alive, and that would be a mark against you.

You might have been cruel and uncaring, for instance, or emotionally distant, or otherwise aloof. For had you not been those things, you would certainly grieve. This, in turn, can explain why the Stoics were (and are) often thought to be so callous – as though they must have advocated such detachment from one’s kith and kin in order to pre-empt any associated suffering.

However, nothing could be further from the truth. As Epictetus instructs, one should not ‘be unfeeling like a statue’ but rather maintain one’s relations, ‘both natural and acquired, as a pious man, a son, a brother, a father, a citizen’. He also repeatedly emphasises that we are social animals, for whom parental and other forms of love come naturally. ‘Even Epicurus,’ he says, derisively, about a philosopher from a competing school, ‘knows that if once a child is born, it will no longer be in our power not to love it or care for it.’

But is it not part of loving one’s child to feel at least some grief when it suffers or dies (you might ask)? Surely feeling no grief would itself be contrary to Nature! For just as virtue cannot exist without wrongdoing, as some Stoics held, so too might the prospect of grief be in some way bound up in love, so that you cannot have one without the other.

The info is here.