Ethical considerations in the use of Pernkopf's Atlas of Anatomy: A surgical case study

Yee, A., Zubovic, E, and others
Surgery May 2019Volume 165, Issue 5, Pages 860–867

Abstract

The use of Eduard Pernkopf's anatomic atlas presents ethical challenges for modern surgery concerning the use of data resulting from abusive scientific work. In the 1980s and 1990s, historic investigations revealed that Pernkopf was an active National Socialist (Nazi) functionary at the University of Vienna and that among the bodies depicted in the atlas were those of Nazi victims. Since then, discussions persist concerning the ethicality of the continued use of the atlas, because some surgeons still rely on information from this anatomic resource for procedural planning. The ethical implications relevant to the use of this atlas in the care of surgical patients have not been discussed in detail. Based on a recapitulation of the main arguments from the historic controversy surrounding the use of Pernkopf's atlas, this study presents an actual patient case to illustrate some of the ethical considerations relevant to the decision of whether to use the atlas in surgery. This investigation aims to provide a historic and ethical framework for questions concerning the use of the Pernkopf atlas in the management of anatomically complex and difficult surgical cases, with special attention to implications for medical ethics drawn from Jewish law.

The info is here.

What a Pediatrician Saw Inside a Border Patrol Warehouse

Jeremy Raff
The Atlantic
Originally posted July 3, 2019

Here are two excerpts:

As agents brought in the children she requested, Sevier said, the smell of sweat and soiled clothing filled the room. They had not been allowed to bathe or change since crossing the Rio Grande and turning themselves over to officials. Sevier found that about two-thirds of the kids she examined had symptoms of respiratory infection. The guards wore surgical masks, but the detainees breathed the air unfiltered. As the children filed in, Sevier said she found evidence of sleep deprivation, dehydration, and malnutrition too.

(cut)

During the exam, she noticed that the toddler behaved differently from the kids his age she sees every day. In an exam room at her clinic decorated with a Lion King mural, I watched her do a routine checkup on a slightly younger boy. This toddler pulled back when Sevier touched him, but was easily soothed by his mother. The reaction was normal—“a small oscillation between worried and okay,” Sevier explained. A little shyness is typical, she said, but toddlers “shouldn't be fearful of a stranger.” When they are afraid—when the memory of their last shots is fresh in their mind, for instance—they resist Sevier by crying, clinging to their caregiver, or squirming beneath her stethoscope.

At Ursula, however, the children Sevier examined—like the panting 2-year-old—were “totally fearful, but then entirely subdued,” she told me. She could read the fear in their faces, but they were perfectly submissive to her authority. “I can only explain it by trauma, because that is such an unusual behavior,” she said. Sevier had brought along Mickey Mouse toys to break the ice, and the kids seem to enjoy playing with them. Yet none resisted, she said, when she took them away at the end of the exam. “At some point,” Sevier mused, “you’re broken and you stop fighting.”

The info is here.

Exposure to opposing views on social media can increase political polarization

Christopher Bail, Lisa Argyle, and others
PNAS September 11, 2018 115 (37) 9216-9221; first published August 28, 2018 https://doi.org/10.1073/pnas.1804840115

Abstract

There is mounting concern that social media sites contribute to political polarization by creating “echo chambers” that insulate people from opposing views about current events. We surveyed a large sample of Democrats and Republicans who visit Twitter at least three times each week about a range of social policy issues. One week later, we randomly assigned respondents to a treatment condition in which they were offered financial incentives to follow a Twitter bot for 1 month that exposed them to messages from those with opposing political ideologies (e.g., elected officials, opinion leaders, media organizations, and nonprofit groups). Respondents were resurveyed at the end of the month to measure the effect of this treatment, and at regular intervals throughout the study period to monitor treatment compliance. We find that Republicans who followed a liberal Twitter bot became substantially more conservative posttreatment. Democrats exhibited slight increases in liberal attitudes after following a conservative Twitter bot, although these effects are not statistically significant. Notwithstanding important limitations of our study, these findings have significant implications for the interdisciplinary literature on political polarization and the emerging field of computational social science.

The research is here.

Happy Fourth of July!!!

Rep. Matt Gaetz to be investigated by House Ethics for tweet apparently threatening Cohen

Emily Kopp
www.rollcall.com
Originally published June 28, 2019


Rep. Matt Gaetz faces an inquiry by the House Ethics Committee for a tweet that appeared to threaten President Donald Trump’s former lawyer Michael Cohen with blackmail.

The House Ethics Committee announced Friday it would establish an investigative subcommittee to review whether the Florida Republican, a staunch ally of the president, sought to intimidate Cohen before he testified before the House Oversight and Reform panel. The Ethics Committee had sought an interview with Gaetz, but he declined, triggering the investigation.

“If members of Congress want to spend their time psychoanalyzing my tweets, it’s certainly their prerogative,” Gaetz said in an emailed statement. “I won’t be joining them in the endeavor.”

Maryland Democrat Anthony G. Brown will serve as the chairman of the investigative subcommittee, while Mississippi RepublicanMichael Guest will be the ranking member. The panel will have the power to issue subpoenas in its pursuit of information, documents and interviews.

The info is here.

U.S. Suicide Rates Are the Highest They've Been Since World War II

Jamie Ducharme
Time.com
Originally posted June 20, 2019

U.S. suicide rates are at their highest since World War II, according to federal data—and the opioid crisis, widespread social media use and high rates of stress may be among the myriad contributing factors.

In 2017, 14 out of every 100,000 Americans died by suicide, according to a new analysis released by the Centers for Disease Control and Prevention’s National Center for Health Statistics. That’s a 33% increase since 1999, and the highest age-adjusted suicide rate recorded in the U.S. since 1942. (Rates were even higher during the Great Depression, hitting a century peak of 21.9 in 1932.)

“I don’t think there’s a one-size-fits all reason” since there’s almost never a single cause of suicide, says Jill Harkavy-Friedman, vice president of research at the American Foundation for Suicide Prevention, a nonprofit that supports suicide prevention research, education and policy. “I don’t think there’s something you can pinpoint, but I do think a period of increased stress and a lack of a sense of security may be contributing.”

It’s even more difficult to assign causes to the uptick, Harkavy-Friedman says, because it’s happening across diverse demographic groups. Men have historically died by suicide more frequently than women, and that’s still true: As of 2017, the male suicide rate was more than three times higher than the female rate. But female suicide rates are rising more quickly—by 53% since 1999, compared to 26% for men—and the gap is narrowing. For both genders, suicide rates are highest among American Indians and Alaska natives, compared to other ethnicities, and when the data are broken down by age group, the most suicide deaths are reported among people ages 45 to 64—but nearly every ethnic and age group saw an increase of some size from 1999 to 2017.

The info is here.

EPA’s top air policy official steps down amid scrutiny over possible ethics violations

The Washington Post
Originally published June 26, 2019

Here is an excerpt:

Less than one month after joining the EPA, Wehrum met with two former clients at his old firm without consulting in advance with ethics officials, even though they had cautioned him about such interactions. That same month, Wehrum participated in a decision that appeared to benefit a former client, DTE Energy, in which then-EPA Administrator Scott Pruitt issued a memo stating that the agency would not be “second guessing utilities” when they projected whether they would need a few federal permits after expanding their operations.

Wehrum, who heads the air and radiation office at the EPA, acknowledged both incidents in an interview with The Post but said he had determined that he did not violate federal ethics rules.

“I have, from day one, tried to be absolutely strict and assiduous as to what I do about complying with my ethical obligations,” Wehrum said, “because it doesn’t do me any good, and it doesn’t do the agency any good, to be doing things that people see as unethical.”

Still, the fallout from reporting on Wehrum’s ties to his former firm and the utility industry by The Post and other outlets — including Politico, the New York Times and E&E News — has continued to reverberate. The Utility Air Regulatory Group, a group of power companies that paid Hunton Andrews Kurth millions in membership dues, disbanded earlier this year.

Wehrum’s decision to leave is the second high-profile EPA resignation in the past year. Last July, Pruitt stepped down after facing probes by Congress, the EPA Office of Inspector General and the Office of Special Counsel for his management and spending practices.

The info is here.

Moral Decision Making, Religious Strain, and the Experience of Moral Injury

Steven Lancaster and Maggie Miller
PsyArXiv Preprints

Abstract

Moral injury is the recognition that acts perpetrated during combat, or other stressful situations, can having lasting psychological impacts. Models of moral injury examine the role of transgressive acts, moral appraisals of these acts, and the symptoms of moral injury. However, little research has examined potential pathways between these elements. The current study examined everyday moral decision making and aspects of religious functioning as possible mediators of these relationships in a military veteran sample. Our pre-registered structural equation model supported a relationship between acts and appraisals; however, this relationship was not mediated by moral decision making as we had hypothesized. Our results demonstrated that religious strain significantly mediated the relationship between moral appraisals and both self- and other-directed symptoms of moral injury. Additional research is needed to better understand how and which transgressive acts are appraised as morally wrong. Further research is also needed to better integrate moral decision making into our understanding of moral injury.

From the Discussion:

Contrary to our predictions, moral decision making did not mediate the relationship between acts and appraisals in our hypothesized model.  This is surprising due to moral conflict being seen as the core of moral injury experience (Jinkerson, 2016).  Given the importance of moral evaluations of one’s actions in moral injury, we expected that one’s “moral compass would make a significant contribution to this model (Drescher & Foy, 2008, p. 99).  It is not clear whether this null finding is due to the method in which moral decision making was assessed or if perhaps moral decision making for everyday experiences (or non-combat experiences) fails to play a role in how one evaluates their potentially transgressive experiences (Christensen & Gomila, 2012).  The EDMD is limited in at least two ways which may have affected our results.  First, the test lacks a contemplation component which is necessary for the psychological processing of an moral decision (Gunia, Wang, Huang, Wang, & Murnighan, 2012).  Second, given that the EDMD focuses on everyday experiences, it may be limited in its ability to assess the moral decisions made during stressful situations (Yousef et al., 2012).  While moral decision making did not mediate as the act-appraisal relationship as hypothesized, it was correlated with other-directed symptoms of moral injury and the MODINDICES output in MPLUS indicated this pathway would improve model fit.  While not hypothesized, one reason for this finding could be that higher altruism leads an individual to give the “benefit of the doubt” to others, particularly those with whom they have endured stressful or traumatic experiences (Staub & Vollhardt, 2008).  Given the relatively young status of the field, additional research is needed to better understand who experiences these acts as negative/wrong and for which types of events does this occur.  Future studies may want to incorporate a broad range of potential mediators including multiple indices of moral decision making.

The pre-print is here.

House Panel Subpoenas Kellyanne Conway over ‘Egregious’ Ethics Violations

Jack Crowe
The National Review
Originally posted June 26, 2019


Here is an excerpt:

Henry J. Kerner, the special counsel, whose role is unrelated to Robert Mueller’s investigation, argued in his Wednesday testimony that Conway’s repeated violations of the Hatch Act — which stem from her endorsement of Republican congressional candidates during television interviews and on Twitter — created an “unprecedented challenge” to his office’s ability to enforce federal law.

Conway has dismissed the accusations of ethics violations as an unprecedented and politically motivated attack on the administration.

“If you’re trying to silence me through the Hatch Act, it’s not going to work,” Conway said when asked about her alleged violations during a May interview, adding “let me know when the jail sentence starts.”

Kerner, in his letter to the president and in his testimony, argued that Conway’s refusal to accept responsibility created a dangerous precedent and was further reason to dismiss her.

Conway’s repeated violations, “combined with her unrepentant attitude, are unacceptable from any federal employee, let alone one in such a prominent position,” Kerner testified.

Representative Elijah Cummings (D., Md.), who chairs the Committee, said he is prepared to hold Conway in contempt if she defies the subpoena.

The info is here.

How do you teach a machine right from wrong? Addressing the morality within Artificial Intelligence

Joseph Brean
The Kingston Whig Standard
Originally published May 30, 2019

Here is an excerpt:

AI “will touch or transform every sector and industry in Canada,” the government of Canada said in a news release in mid-May, as it named 15 experts to a new advisory council on artificial intelligence, focused on ethical concerns. Their goal will be to “increase trust and accountability in AI while protecting our democratic values, processes and institutions,” and to ensure Canada has a “human-centric approach to AI, grounded in human rights, transparency and openness.”

It is a curious project, helping computers be more accountable and trustworthy. But here we are. Artificial intelligence has disrupted the basic moral question of how to assign responsibility after decisions are made, according to David Gunkel, a philosopher of robotics and ethics at Northern Illinois University. He calls this the “responsibility gap” of artificial intelligence.

“Who is able to answer for something going right or wrong?” Gunkel said. The answer, increasingly, is no one.

It is a familiar problem that is finding new expressions. One example was the 2008 financial crisis, which reflected the disastrous scope of automated decisions. Gunkel also points to the success of Google’s AlphaGo, a computer program that has beaten the world’s best players at the famously complex board game Go. Go has too many possible moves for a computer to calculate and evaluate them all, so the program uses a strategy of “deep learning” to reinforce promising moves, thereby approximating human intuition. So when it won against the world’s top players, such as top-ranked Ke Jie in 2017, there was confusion about who deserved the credit. Even the programmers could not account for the victory. They had not taught AlphaGo to play Go. They had taught it to learn Go, which it did all by itself.

The info is here.