Fostering an Ethical Culture on Your Sales Team

Kristen Bell DeTienne, Bradley R. Agle, and others
Harvard Business Review
Originally posted June 20, 2019

Here is an excerpt:

Create a Culture of Ethical Values. 

Employees can suffer several negative consequences if they are told to do things that conflict with their ethical values. Meanwhile, companies can suffer negative consequences from employees not living up to the organization’s values. Managers can help by involving sales associates in conversations about personal and organizational values and by helping employees reconcile discrepancies and honor both their personal and organizational values.

During one of our ethics training sessions with a U.S.-based corporation, employees first described their own values and the company’s values. In teams, they set goals for sales achievement, then wrote a code of conduct that would promote that achievement while still respecting both individual and company values. One associate’s value was “not to push the clients too much when they need time to decide.” This seemed at odds with the company’s values to “finalize the sale” and “never abandon an opportunity.” So, the employees created a rule that honored both values: “Give your customers the time they need to think about your offer, but immediately fix the next appointment.” This hybrid rule brought peace of mind to employees—and a better sales experience to their customers.

The info is here.

Association Between Life Purpose and Mortality Among US Adults Older Than 50 Years

Aliya Alimujiang, Ashley Wiensch, Jonathan Boss, and others
JAMA Network Open 2019;2(5):e194270. 

Abstract

Importance  A growing body of literature suggests that having a strong sense of purpose in life leads to improvements in both physical and mental health and enhances overall quality of life. There are interventions available to influence life purpose; thus, understanding the association of life purpose with mortality is critical.

Objective  To evaluate whether an association exists between life purpose and all-cause or cause-specific mortality among older adults in the United States.

Main Outcomes and Measures  All-cause and cause-specific mortality were assessed between 2006 and 2010. Weighted Cox proportional hazards models were used to evaluate life purpose and mortality.

Results  Of 6985 individuals included in the analysis, 4016 (57.5%) were women, the mean (SD) age of all participants was 68.6 (9.8) years, and the mean (SD) survival time for decedents was 31.21 (15.42) months (range, 1.00-71.00 months). Life purpose was significantly associated with all-cause mortality in the HRS (hazard ratio, 2.43; 95% CI, 1.57-3.75, comparing those in the lowest life purpose category with those in the highest life purpose category). Some significant cause-specific mortality associations with life purpose were also observed (heart, circulatory, and blood conditions: hazard ratio, 2.66; 95% CI, 1.62-4.38).

Conclusions and Relevance  This study’s results indicated that stronger purpose in life was associated with decreased mortality. Purposeful living may have health benefits. Future research should focus on evaluating the association of life purpose interventions with health outcomes, including mortality. In addition, understanding potential biological mechanisms through which life purpose may influence health outcomes would be valuable.

The research is here.

Does psychology have a conflict-of-interest problem?

Tom Chivers
Nature
Originally published July 2, 2019

Here is an excerpt:

But other psychologists say they think personal speaking fees ought to be declared. There is no suggestion that any scientists are deliberately skewing their results to maintain their speaking income. But critics say that lax COI disclosure norms could create problems by encouraging some scientists to play down — perhaps unconsciously — findings that contradict their arguments, and could lead them to avoid declaring other conflicts. “A lot of researchers don’t know where to draw the line [on COIs],” says Chris Chambers, a psychologist at the University of Cardiff, UK, who is an editor for five journals, including one on psychology. “And because there are no norms they gravitate to saying nothing.”

Researchers who spoke to Nature about their concerns say they see the issue as connected to psychology’s greater need for self-scrutiny because of some high-profile cases of misconduct, as well as to broader concerns about the reproducibility of results. “Even the appearance of an undisclosed conflict of interest can be damaging to the credibility of psychological science,” says Scott Lilienfeld, the editor-in-chief of Clinical Psychological Science (CPS), which published papers of Twenge’s in 2017 and 2018. “The heuristic should be ‘when in doubt, declare’,” he says (although he added that he did not have enough information to judge Twenge’s non-disclosures in CPS). Psychology, he adds, needs to engage in a “thoroughgoing discussion of what constitutes a conflict of interest, and when and how such conflicts should be disclosed”.

The info is here.

A Waste of 1,000 Research Papers

Ed Yong
The Atlantic
Originally posted May 17, 2019

In 1996, a group of European researchers found that a certain gene, called SLC6A4, might influence a person’s risk of depression.

It was a blockbuster discovery at the time. The team found that a less active version of the gene was more common among 454 people who had mood disorders than in 570 who did not. In theory, anyone who had this particular gene variant could be at higher risk for depression, and that finding, they said, might help in diagnosing such disorders, assessing suicidal behavior, or even predicting a person’s response to antidepressants.

Back then, tools for sequencing DNA weren’t as cheap or powerful as they are today. When researchers wanted to work out which genes might affect a disease or trait, they made educated guesses, and picked likely “candidate genes.” For depression, SLC6A4 seemed like a great candidate: It’s responsible for getting a chemical called serotonin into brain cells, and serotonin had already been linked to mood and depression. Over two decades, this one gene inspired at least 450 research papers.

But a new study—the biggest and most comprehensive of its kind yet—shows that this seemingly sturdy mountain of research is actually a house of cards, built on nonexistent foundations.

Richard Border of the University of Colorado at Boulder and his colleagues picked the 18 candidate genes that have been most commonly linked to depression—SLC6A4 chief among them. Using data from large groups of volunteers, ranging from 62,000 to 443,000 people, the team checked whether any versions of these genes were more common among people with depression. “We didn’t find a smidge of evidence,” says Matthew Keller, who led the project.

The info is here.

Making Policy on Augmented Intelligence in Health Care

Elliott Crigger and Christopher Khoury
AMA J Ethics. 2019;21(2):E188-191.
doi: 10.1001/amajethics.2019.188

Abstract

In June 2018, the American Medical Association adopted new policy to provide a broad framework for the evolution of artificial intelligence (AI) in health care that is designed to help ensure that AI realizes the benefits it promises for patients, physicians, and the health care community.

Here is the end of the article:

The AMA’s adoption of H-480.940 suggests the ethical importance of these questions in calling for development of thoughtfully designed, high-quality, clinically validated health care AI that does the following:

a) is designed and evaluated in keeping with best practices in user-centered design, particularly for physicians and other members of the health care team;
b) is transparent;
c) conforms to leading standards for reproducibility;
d) identifies and takes steps to address bias and avoids introducing or exacerbating health care disparities including when testing or deploying new AI tools on vulnerable populations; and
e) safeguards patients’ and other individuals’ privacy interests and preserves the security and integrity of personal information.

Values of ethical relevance considered in this policy include professionalism, transparency, justice, safety, and privacy.

The info is here.

Prediction Models for Suicide Attempts and Deaths: A Systematic Review and Simulation

Bradley Belsher, Derek Smolenski, Larry Pruitt, and others
JAMA Psychiatry. 2019;76(6):642-651.
doi:10.1001/jamapsychiatry.2019.0174

Abstract
Importance  Suicide prediction models have the potential to improve the identification of patients at heightened suicide risk by using predictive algorithms on large-scale data sources. Suicide prediction models are being developed for use across enterprise-level health care systems including the US Department of Defense, US Department of Veterans Affairs, and Kaiser Permanente.

Objectives
To evaluate the diagnostic accuracy of suicide prediction models in predicting suicide and suicide attempts and to simulate the effects of implementing suicide prediction models using population-level estimates of suicide rates.

Evidence Review
A systematic literature search was conducted in MEDLINE, PsycINFO, Embase, and the Cochrane Library to identify research evaluating the predictive accuracy of suicide prediction models in identifying patients at high risk for a suicide attempt or death by suicide. Each database was searched from inception to August 21, 2018. The search strategy included search terms for suicidal behavior, risk prediction, and predictive modeling. Reference lists of included studies were also screened. Two reviewers independently screened and evaluated eligible studies.

Findings
From a total of 7306 abstracts reviewed, 17 cohort studies met the inclusion criteria, representing 64 unique prediction models across 5 countries with more than 14 million participants. The research quality of the included studies was generally high. Global classification accuracy was good (≥0.80 in most models), while the predictive validity associated with a positive result for suicide mortality was extremely low (≤0.01 in most models). Simulations of the results suggest very low positive predictive values across a variety of population assessment characteristics.

Conclusions and Relevance
To date, suicide prediction models produce accurate overall classification models, but their accuracy of predicting a future event is near 0. Several critical concerns remain unaddressed, precluding their readiness for clinical applications across health systems.

Time to End Physician Sexual Abuse of Patients: Calling the U.S. Medical Community to Action

AbuDagga, A., Carome, M. & Wolfe, S.M.
J GEN INTERN MED (2019).
https://doi.org/10.1007/s11606-019-05014-6

Abstract

Despite the strict prohibition against all forms of sexual relations between physicians and their patients, some physicians cross this bright line and abuse their patients sexually. The true extent of sexual abuse of patients by physicians in the U.S. health care system is unknown. An analysis of National Practitioner Data Bank reports of adverse disciplinary actions taken by state medical boards, peer-review sanctions by institutions, and malpractice payments shows that a very small number of physicians have faced “reportable” consequences for this unethical behavior. However, physician self-reported data suggest that the problem occurs at a higher rate. We discuss the factors that can explain why such sexual abuse of patients is a persistent problem in the U.S. health care system. We implore the medical community to begin a candid discussion of this problem and call for an explicit zero-tolerance standard against sexual abuse of patients by physicians. This standard must be coupled with regulatory, institutional, and cultural changes to realize its promise. We propose initial recommendations toward that end.

Congress weighs dropping ban on altering the DNA of human embryos used for pregnancies

Sharon Begley and Andrew Joseph
www.statnews.xom
Originally posted June 4, 2019

A congressional committee is expected to vote on Tuesday to drop a ban on altering the genomes of human embryos intended for pregnancies, which could open the door to creating babies with genetic material from three people or with genomes that have been modified in a way that would be inherited by their descendants, as China’s “CRISPR babies” were.

The prohibition on modifying the DNA of embryos for reproduction (as opposed to doing so in basic research that stops short of pregnancies) has been attached to bills that fund the Food and Drug Administration since December 2015. But last month, a House appropriations subcommittee approved a version of an FDA spending bill without the amendment, or rider — amid worldwide condemnation of the CRISPR babies experiment last year and calls by leading scientists for a global moratorium on creating gene-edited babies.

“People don’t appreciate that this is the only piece of legislation in the United States that stands between us and genetically engineered children,” said science historian J. Benjamin Hurlbut of Arizona State University, who supports a “global observatory” to track uses of CRISPR, the powerful genome-editing technology.

The info is here.

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.