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

Saturday, April 13, 2019

Nudging the better angels of our nature: A field experiment on morality and well-being.

Adam Waytz, & Wilhelm Hofmann
Emotion, Feb 28 , 2019, No Pagination Specified

Abstract

A field experiment examines how moral behavior, moral thoughts, and self-benefiting behavior affect daily well-being. Using experience sampling technology, we randomly grouped participants over 10 days to either behave morally, have moral thoughts, or do something positive for themselves. Participants received treatment-specific instructions in the morning of 5 days and no instructions on the other 5 control days. At each day’s end, participants completed measures that examined, among others, subjective well-being, self-perceived morality and empathy, and social isolation and closeness. Full analyses found limited evidence for treatment- versus control-day differences. However, restricting analyses to occasions on which participants complied with instructions revealed treatment- versus control-day main effects on all measures, while showing that self-perceived morality and empathy toward others particularly increased in the moral deeds and moral thoughts group. These findings suggest that moral behavior, moral thoughts, and self-benefiting behavior are all effective means of boosting well-being, but only moral deeds and, perhaps surprisingly, also moral thoughts strengthen the moral self-concept and empathy. Results from an additional study assessing laypeople’s predictions suggest that people do not fully intuit this pattern of results.

Here is part of the Discussion:

Overall, inducing moral thoughts and behaviors toward others enhanced feelings of virtuousness compared to the case for self-serving behavior. This makes sense given that people likely internalized their moral thoughts and behaviors in the two moral conditions, whereas the treat-yourself condition did not direct participants toward morality. Restricting analyses to days when people complied with treatment-specific instructions revealed significant positive effects on satisfaction for all treatments. That is, compared to receiving no instructions to behave morally, think morally, or treat oneself, receiving and complying with such instructions on treatment-specific days increased happiness and satisfaction with one’s life. Although the effect size was highest in the treat-yourself condition, improvements in satisfaction were statistically equivalent across conditions. Overall, the moral deeds condition in this compliant-only analysis revealed the broadest improvements across other measures related to well-being, whereas the treat-yourself condition was the only condition to significantly reduce exhaustion. Examining instances when participants reported behaving morally, thinking morally, or behaving self-servingly, independent of treatment, revealed comparable results for moral deeds and self-treats enhancing well-being generally, with moral thoughts enhancing most measures of well-being as well.

The research is here.

Friday, April 12, 2019

It’s Not Enough to Be Right—You Also Have to Be Kind

Ryan Holiday
www.medium.com
Originally posted on March 20, 2019

Here is an excerpt:

Reason is easy. Being clever is easy. Humiliating someone in the wrong is easy too. But putting yourself in their shoes, kindly nudging them to where they need to be, understanding that they have emotional and irrational beliefs just like you have emotional and irrational beliefs—that’s all much harder. So is not writing off other people. So is spending time working on the plank in your own eye than the splinter in theirs. We know we wouldn’t respond to someone talking to us that way, but we seem to think it’s okay to do it to other people.

There is a great clip of Joe Rogan talking during the immigration crisis last year. He doesn’t make some fact-based argument about whether immigration is or isn’t a problem. He doesn’t attack anyone on either side of the issue. He just talks about what it feels like—to him—to hear a mother screaming for the child she’s been separated from. The clip has been seen millions of times now and undoubtedly has changed more minds than a government shutdown, than the squabbles and fights on CNN, than the endless op-eds and think-tank reports.

Rogan doesn’t even tell anyone what to think. (Though, ironically, the clip was abused by plenty of editors who tried to make it partisan). He just says that if you can’t relate to that mom and her pain, you’re not on the right team. That’s the right way to think about it.

The info is here.

Not “burnout,” not moral injury—human rights violations

Pamela Wible
www.idealcare.org
Originally posted March 18, 2019

Here is an excerpt:

Moral injury now extends beyond combat veterans to include physicians in 2018 when Dean and Talbot announced their opposition and alternative to the label physician “burnout.” They believe (as I do) that physician cynicism, exhaustion, and decreased productivity are symptoms of a broken system. Economic forces, technological demands, and widespread intergenerational physician mental health wounds have culminated in a highly dysfunctional and toxic health care system in which we find ourselves in daily forced betrayal of our deepest values.

Manifestations of moral injury in victims include self-harm, poor self-care, substance abuse, recklessness, self-defeating behaviors, hopelessness, self-loathing, and decreased empathy. I’ve witnessed all far too frequently among physicians.

Yet moral injury is not an official diagnosis. No specific solutions are offered at medical institutions to combat physician moral injury though moral injury treatment among military may include listening circles (where veterans share battlefield stories), forgiveness rituals, and individual therapy. The fact is most victims of moral injury struggle on their own.

With no evidence-based treatments for physician moral injury and zero progress after forty years of burnout prevention, what next? Enter the real diagnosis—human rights violations—with clear evidence-based solutions.

The info is here.

Thursday, April 11, 2019

6 women sexually abused by counselor at women's rehab center Timberline Knolls, prosecutors say

David Jackson
The Chicago Tribune
Originally posted March 7, 2019

Here is an excerpt:

Cook County prosecutors allege that a Timberline Knolls counselor, Mike Jacksa, sexually assaulted or abused six patients last year at the leafy 43-acre rehab center in suburban Lemont. Former patients told police that Jacksa subjected them to rape, forced oral sex, digital penetration and fondling beneath their clothes. He faces 62 felony charges.

The abuse allegations began to surface last summer, but Timberline officials waited at least three weeks to contact law enforcement, police reports show. In the meantime, Timberline staff conducted internal investigations, twice suspending and reinstating Jacksa, police records show.

In early July, when Timberline staff discovered journal entries by a patient that described her sexual encounters with Jacksa, they confronted the woman in his presence, police reports show. Afterward, the woman “went back to her lodge and broke a mirror, intending to hurt herself or commit suicide over the embarrassment and emotional distress the whole situation with Jacksa had caused,” a Lemont police report said. “She was transported to a hospital.”

Widely accepted treatment standards say people who report sex crimes should not be forced to give their accounts in front of their alleged attackers.

Timberline Knolls suspended Jacksa a third time in early August, after the police got involved, then fired him Aug. 10. His alleged sexual attacks on patients were “an isolated incident,” said Timberline spokesman Gary Mack. “Facility administrators were greatly saddened by this whole situation and believed they acted swiftly and certainly to take Jacksa off the street.”

The info is here.

GAO urges more transparency of political appointments, compliance with agency ethics programs

Nicole Ogrysko
www.federalnewsnetwork.com
Originally posted March 15, 2019

The Government Accountability Office is urging Congress to require more transparency of agencies in collecting and publishing information on political appointees in the executive branch.

A new GAO study describing agencies’ struggles to track political appointees and their compliance with ethics programs reads, in a sense, like a greatest hits album of typical challenges pestering many facets of government.

Agency data tracking the appointments and departures of political officials, for example, is inconsistent and scattered across multiple systems and organizations. And challenges in recruitment, retention and training have led to persistent vacancies at departmental ethics offices.

“The public has an interest in knowing who is serving in the government and making policy decisions. The Office of Management and Budget stated that transparency promotes accountability by providing the public with information about what the government is doing,” GAO wrote. “Until the names of political appointees and their position, position type, agency or department name, start and end dates are publicly available at least quarterly, it will be difficult for the public to access comprehensive and reliable information.”

The info is here.

Wednesday, April 10, 2019

FDA Chief Scott Gottlieb Calls for Tighter Regulations on Electronic Health Records

Fred Schulte and Erika Fry
Fortune.com
Originally posted March 21, 2019

Food and Drug Administration Commissioner Scott Gottlieb on Wednesday called for tighter scrutiny of electronic health records systems, which have prompted thousands of reports of patient injuries and other safety problems over the past decade.

“What we really need is a much more tailored approach, so that we have appropriate oversight of EHRs when they’re doing things that could create risk for patients,” Gottlieb said in an interview with Kaiser Health News.

Gottlieb was responding to “Botched Operation,” a report published this week by KHN and Fortune. The investigation found that the federal government has spent more than $36 billion over the past 10 years to switch doctors and hospitals from paper to digital records systems. In that time, thousands of reports of deaths, injuries, and near misses linked to EHRs have piled up in databases—including at least one run by the FDA.

The info is here.

Gov. Newsom to order halt to California’s death penalty

Bob Egelko and Alexei Koseff
San Francisco Chronicle
Originally posted March 12, 2019

Gov. Gavin Newsom is suspending the death penalty in California, calling it discriminatory and immoral, and is granting reprieves to the 737 condemned inmates on the nation’s largest Death Row.

“I do not believe that a civilized society can claim to be a leader in the world as long as its government continues to sanction the premeditated and discriminatory execution of its people,” Newsom said in a statement accompanying an executive order, to be issued Wednesday, declaring a moratorium on capital punishment in the state. “The death penalty is inconsistent with our bedrock values and strikes at the very heart of what it means to be a Californian.”

He plans to order an immediate shutdown of the death chamber at San Quentin State Prison, where the last execution was carried out in 2006. Newsom is also withdrawing California’s recently revised procedures for executions by lethal injection, ending — at least for now — the struggle by prison officials for more than a decade to devise procedures that would pass muster in federal court by minimizing the risk of a botched and painful execution.

The info is here.

Tuesday, April 9, 2019

U.S. Ethics Office Declines to Certify Mnuchin’s Financial Disclosure

Alan Rappeport
The New York Times
Originally published April 4, 2019

The top federal ethics watchdog said on Thursday that Treasury Secretary Steven Mnuchin’s sale of his stake in a film production business to his wife did not comply with federal ethics rules, and it would not certify his 2018 financial disclosure report as a result.

Although Mr. Mnuchin will not face penalties for failing to comply, he has been required to rewrite his federal ethics agreement and to promise to recuse himself from government matters that could affect his wife’s business.

Mr. Mnuchin in 2017 sold his stake in StormChaser Partners to his then-fiancée, Louise Linton, as part of a series of divestments before becoming Treasury secretary. Since they are now married, government ethics rules consider the asset to be owned by Mr. Mnuchin, potentially creating a conflict of interest for an official who has been negotiating for expanded access for the movie industry as part of trade talks with China.

The controversy over Mr. Mnuchin’s finances has become an unwanted distraction in recent weeks as the Trump administration has been engaged in intense negotiations with China on a wide range of trade matters. While Robert Lighthizer, President Trump’s top trade official, has been leading the talks, Mr. Mnuchin has been the point person for promoting the film industry because of his background as a Hollywood producer and investor.

The info is here.

N.J. approves bill giving terminally ill people the right to end their lives

Susan Livio
www.nj.com
Originally posted March 25, 2019

New Jersey is poised to become the eighth state to allow doctors to write a lethal prescription for terminally ill patients who want to end their lives.

The state Assembly voted 41-33 with four abstentions Monday to pass the “Medical Aid in Dying for the Terminally Ill Act." Minutes later, the state Senate approved the bill 21-16.

Gov. Phil Murphy later issued a statement saying he would sign the measure into law.

“Allowing terminally ill and dying residents the dignity to make end-of-life decisions according to their own consciences is the right thing to do," the Democratic governor said. "I look forward to signing this legislation into law.”

The measure (A1504) would take effect four months after it is signed.

Susan Boyce, 55 of Rumson, smiled and wept after the final vote.

“I’ve been working on this quite a while," said Boyce, who is diagnosed with a terminal auto immune disease, Alpha-1 antitrypsin deficiency, and needs an oxygen tank to breathe.

The info is here.