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

Thursday, October 4, 2018

7 Short-Term AI ethics questions

Orlando Torres
www.towardsdatascience.com
Originally posted April 4, 2018

Here is an excerpt:

2. Transparency of Algorithms

Even more worrying than the fact that companies won’t allow their algorithms to be publicly scrutinized, is the fact that some algorithms are obscure even to their creators.
Deep learning is a rapidly growing technique in machine learning that makes very good predictions, but is not really able to explain why it made any particular prediction.

For example, some algorithms haven been used to fire teachers, without being able to give them an explanation of why the model indicated they should be fired.

How can we we balance the need for more accurate algorithms with the need for transparency towards people who are being affected by these algorithms? If necessary, are we willing to sacrifice accuracy for transparency, as Europe’s new General Data Protection Regulation may do? If it’s true that humans are likely unaware of their true motives for acting, should we demand machines be better at this than we actually are?

3. Supremacy of Algorithms

A similar but slightly different concern emerges from the previous two issues. If we start trusting algorithms to make decisions, who will have the final word on important decisions? Will it be humans, or algorithms?

For example, some algorithms are already being used to determine prison sentences. Given that we know judges’ decisions are affected by their moods, some people may argue that judges should be replaced with “robojudges”. However, a ProPublica study found that one of these popular sentencing algorithms was highly biased against blacks. To find a “risk score”, the algorithm uses inputs about a defendant’s acquaintances that would never be accepted as traditional evidence.

The info is here.

Shouldn’t We Make It Easy to Use Behavioral Science for Good?

Manasee Desai
www.behavioralscientist.org
Originally posted September 4, 2018

The evidence showing that applied behavioral science is a powerful tool for creating social good is growing rapidly. As a result, it’s become much more common for the world’s problem solvers to apply a behavioral lens to their work. Yet this approach can still feel distant to the people trying urgently to improve lives on a daily basis—those working for governments, nonprofits, and other organizations that directly tackle some of the most challenging and pervasive problems facing us today.

All too often, effective strategies for change are either locked behind paywalls or buried in inaccessible, jargon-laden articles. And because of the sheer volume of behavioral solutions being tested now, even people working in the fields that compose the behavioral sciences—like me, for instance—cannot possibly stay on top of every new intervention or application happening across countless fields and countries. This means missed opportunities to apply and scale effective interventions and to do more good in the world.

As a field, figuring out how to effectively report and communicate what we’ve learned from our research and interventions is our own “last mile” problem.

While there is no silver bullet for the problems the world faces, the behavioral science community should (and can) come together to make our battle-tested solutions available to problem solvers, right at their fingertips. Expanding the adoption of behavioral design for social good requires freeing solutions from dense journals and cost-prohibitive paywalls. It also requires distilling complex designs into simpler steps—uniting a community that is passionate about social impact and making the world a better place with applied behavioral science.

That is the aim of the Behavioral Evidence Hub (B-Hub), a curated, open-source digital collection of behavioral interventions proven to impact real-world problems.

The info is here.

Wednesday, October 3, 2018

Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction: A Systematic Review and Meta-analysis.

Maria Panagioti, PhD; Keith Geraghty, PhD; Judith Johnson, PhD; et al
JAMA Intern Med. Published online September 4, 2018.
doi:10.1001/jamainternmed.2018.3713

Abstract

Importance  Physician burnout has taken the form of an epidemic that may affect core domains of health care delivery, including patient safety, quality of care, and patient satisfaction. However, this evidence has not been systematically quantified.

Objective  To examine whether physician burnout is associated with an increased risk of patient safety incidents, suboptimal care outcomes due to low professionalism, and lower patient satisfaction.

Data Sources  MEDLINE, EMBASE, PsycInfo, and CINAHL databases were searched until October 22, 2017, using combinations of the key terms physicians, burnout, and patient care. Detailed standardized searches with no language restriction were undertaken. The reference lists of eligible studies and other relevant systematic reviews were hand-searched.

Data Extraction and Synthesis  Two independent reviewers were involved. The main meta-analysis was followed by subgroup and sensitivity analyses. All analyses were performed using random-effects models. Formal tests for heterogeneity (I2) and publication bias were performed.

Main Outcomes and Measures  The core outcomes were the quantitative associations between burnout and patient safety, professionalism, and patient satisfaction reported as odds ratios (ORs) with their 95% CIs.

Results  Of the 5234 records identified, 47 studies on 42 473 physicians (25 059 [59.0%] men; median age, 38 years [range, 27-53 years]) were included in the meta-analysis. Physician burnout was associated with an increased risk of patient safety incidents (OR, 1.96; 95% CI, 1.59-2.40), poorer quality of care due to low professionalism (OR, 2.31; 95% CI, 1.87-2.85), and reduced patient satisfaction (OR, 2.28; 95% CI, 1.42-3.68). The heterogeneity was high and the study quality was low to moderate. The links between burnout and low professionalism were larger in residents and early-career (≤5 years post residency) physicians compared with middle- and late-career physicians (Cohen Q = 7.27; P = .003). The reporting method of patient safety incidents and professionalism (physician-reported vs system-recorded) significantly influenced the main results (Cohen Q = 8.14; P = .007).

Conclusions and Relevance  This meta-analysis provides evidence that physician burnout may jeopardize patient care; reversal of this risk has to be viewed as a fundamental health care policy goal across the globe. Health care organizations are encouraged to invest in efforts to improve physician wellness, particularly for early-career physicians. The methods of recording patient care quality and safety outcomes require improvements to concisely capture the outcome of burnout on the performance of health care organizations.

The research is here.

Moral Reasoning

Richardson, Henry S.
The Stanford Encyclopedia of Philosophy (Fall 2018 Edition), Edward N. Zalta (ed.)

Here are two brief excerpts:

Moral considerations often conflict with one another. So do moral principles and moral commitments. Assuming that filial loyalty and patriotism are moral considerations, then Sartre’s student faces a moral conflict. Recall that it is one thing to model the metaphysics of morality or the truth conditions of moral statements and another to give an account of moral reasoning. In now looking at conflicting considerations, our interest here remains with the latter and not the former. Our principal interest is in ways that we need to structure or think about conflicting considerations in order to negotiate well our reasoning involving them.

(cut)

Understanding the notion of one duty overriding another in this way puts us in a position to take up the topic of moral dilemmas. Since this topic is covered in a separate article, here we may simply take up one attractive definition of a moral dilemma. Sinnott-Armstrong (1988) suggested that a moral dilemma is a situation in which the following are true of a single agent:

  1. He ought to do A.
  2. He ought to do B.
  3. He cannot do both A and B.
  4. (1) does not override (2) and (2) does not override (1).

This way of defining moral dilemmas distinguishes them from the kind of moral conflict, such as Ross’s promise-keeping/accident-prevention case, in which one of the duties is overridden by the other. Arguably, Sartre’s student faces a moral dilemma. Making sense of a situation in which neither of two duties overrides the other is easier if deliberative commensurability is denied. Whether moral dilemmas are possible will depend crucially on whether “ought” implies “can” and whether any pair of duties such as those comprised by (1) and (2) implies a single, “agglomerated” duty that the agent do both A and B. If either of these purported principles of the logic of duties is false, then moral dilemmas are possible.

The entry is here.

Tuesday, October 2, 2018

For the first time, researchers will release genetically engineered mosquitoes in Africa

Ike Swetlitz
www.statnews.com
Originally posted September 5, 2018

The government of Burkina Faso granted scientists permission to release genetically engineered mosquitoes anytime this year or next, researchers announced Wednesday. It’s a key step in the broader efforts to use bioengineering to eliminate malaria in the region.

The release, which scientists are hoping to execute this month, will be the first time that any genetically engineered animal is released into the wild in Africa. While these particular mosquitoes won’t have any mutations related to malaria transmission, researchers are hoping their release, and the work that led up to it, will help improve the perception of the research and trust in the science among regulators and locals alike. It will also inform future releases.

Teams in three African countries — Burkina Faso, Mali, and Uganda — are building the groundwork to eventually let loose “gene drive” mosquitoes, which would contain a mutation that would significantly and quickly reduce the mosquito population. Genetically engineered mosquitoes have already been released in places like Brazil and the Cayman Islands, though animals with gene drives have never been released in the wild.

The info is here.

Philosophy of Multicultures

Owen Flanagan
Philosophers Magazine
Originally published August 19, 2018

Here is an excerpt:

First, as I have been insisting, we live increasingly in multicultural, multiethnic, cosmopolitan worlds. Depending on one’s perspective these worlds are grand experiments in tolerant living, worlds in which prejudices break down; or they are fractured, wary, tense ethnic and religious cohousing projects; or they are melting pots where differences are thinned out and homogenised over time; or they are admixtures or collages of the best values, norms, and practices, the sociomoral equivalent of fine fusion cuisine or excellent world music that creates flavours or sounds from multiple fine sources; or on the other side, a blend of the worst of incommensurable value systems and practices, clunky and degenerate. It is good for ethicists to know more about people who are not from the North Atlantic (or its outposts). Or even if they are from the North Atlantic are not from elites or are not from “around here”. It matters how members of original displaced communities or people who were brought here or came here as chattel slaves or indentured workers or political refugees or for economic opportunity, have thought about virtues, values, moral psychology, normative ethics, and good human lives.

Second, most work in empirical moral psychology has been done on WEIRD people (Western Educated Industrialised Rich Democratic) and there is every reason to think WEIRD people are unrepresentative, possibly the most unrepresentative group imaginable, less representative than our ancestors when the ice melted at the end of the Pleistocene. It may be the assumptions we make about the nature of persons and the human good in the footnotes to Plato lineage and which seem secure are in fact parochial and worth re-examining.

Third, the methods of genetics, empirical psychology, evolutionary psychology, and neuroscience get lots of attention recently in moral psychology, as if they can ground an entirely secular and neutral form of common life. But it would be a mistake to think that these sciences are superior to the wisdom of the ages in gaining deep knowledge about human nature and the human good or that they are robust enough to provide a picture of a good life.

The info is here.

Monday, October 1, 2018

Moral Injury in International Relations

Jelena Subotic & Brent J Steele
Journal of Global Security Studies
https://doi.org/10.1093/jogss/ogy021
Published: 28 August 2018

Abstract

The war in Iraq unleashed disastrous global instability—from the strengthening of Al-Qaeda, to the creation of ISIS, and civil war in Syria accompanied by a massive exodus of refugees. The war in Afghanistan is continuing in perpetuity, with no clear goals or objectives other than the United States’ commitment to its sunk cost. The so-called war on terror is a vague catch-all phrase for a military campaign against moving targets and goalposts, with no end date and no conceivable way to declare victory. The toll of these wars on civilians in Iraq and Afghanistan and elsewhere in the Middle East, on US troops, and on the US economy is staggering. But these ambiguous campaigns are also fundamentally changing US state identity—its view of itself, its role in the world, and its commitment to a liberal international order. They are producing profound anxiety in the US body politic and anxiety in US relationships with other international actors. To understand the sources and consequences of this anxiety, we adopt an ontological security perspective on state identity. We enrich ontological security scholarship by introducing the concept of moral injury and its three main consequences: loss of control, ethical anxiety, and relational harm. We demonstrate how the concept of moral injury illuminates some of the most central anxieties at the core of US identity, offering a new understanding of our global moment of crisis.

The info is here.

How Do Medicalization and Rescue Fantasy Prevent Healthy Dying?

Peter T. Hetzler III and Lydia S. Dugdale
AMA Journal of Ethics
2018;20(8):E766-773.

Abstract

Before antibiotics, cardiopulmonary resuscitation (CPR), and life-sustaining technologies, humans had little choice about the timing and manner of their deaths. Today, the medicalization of death has enabled patients to delay death, prolonging their living and dying. New technology, the influence of the media, and medical professionals themselves have together transformed dying from a natural part of the human experience into a medical crisis from which a patient must be rescued, often through the aggressive extension of life or through its premature termination. In this paper, we examine problematic forms of rescue medicine and suggest the need to rethink medicalized dying within the context of medicine’s orientation to health and wholeness.

The info is here.

Sunday, September 30, 2018

Why It’s So Hard to Be an ‘Ethical’ Investor

Jon Sindreu and Sarah Kent
The Wall Street Journal
Originally posted September 1, 2018

In life, ethics are in the eye of the beholder. In investing, ethics are up to the whims of your fund manager.

With little regulation governing what a fund manager can call a “socially responsible” or “ethical” investment, a myriad of bespoke standards have popped up. Increasingly, these fund strategies are designed to beat the market rather than uphold morality.

This has created a dizzying of array possibilities when it comes to what these funds might hold. Fund companies can craft their definitions in such a way that they can simply rename existing products with an ethical allusion, without having to change their fund holdings.

Fund managers have rebranded at least two dozen existing mutual funds over the past few years, adding terms such as “sustainable,” and “ESG”—which stands for environmental, social and corporate governance, an industry buzzword.

The info is here.