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, October 12, 2019

Lolita understood that some sex is transactional. So did I

<p>Detail from film poster for <em>Lolita </em>(1962). <em>Photo by Getty</em></p>Tamara MacLeod
aeon.co
Originally published September 11, 2019

Here is an excerpt:

However, I think that it is the middle-class consciousness of liberal feminism that excluded sex work from its platform. After all, wealthier women didn’t need to do sex work as such; they operated within the state-sanctioned transactional boundaries of marriage. The dissatisfaction of the 20th-century housewife was codified as a struggle for liberty and independence as an addition to subsidised material existence, making a feminist discourse on work less about what one has to do, and more about what one wants to do. A distinction within women’s work emerged: if you don’t enjoy having sex with your husband, it’s just a problem with the marriage. If you don’t enjoy sex with a client, it’s because you can’t consent to your own exploitation. It is a binary view of sex and consent, work and not-work, when the reality is somewhat murkier. It is a stubborn blindness to the complexity of human relations, and maybe of human psychology itself, descending from the viscera-obsessed, radical absolutisms of Andrea Dworkin.

The housewife who married for money and then fakes orgasms, the single mother who has sex with a man she doesn’t really like because he’s offering her some respite: where are the delineations between consent and exploitation, sex and duty? The first time I traded sex for material gain, I had some choices, but they were limited. I chose to be exploited by the man with the resources I needed, choosing his house over homelessness. Lolita was a child, and she was exploited, but she was also conscious of the function of her body in a patriarchal economy. Philosophically speaking, most of us do indeed consent to our own exploitation.

The info is here.

Friday, October 11, 2019

Dying is a Moral Event. NJ Law Caught Up With Morality

T. Patrick Hill
Star-Ledge Guest Column
Originally posted September 9, 2019

New Jersey’s Medical-Aid-in-Dying legislation authorizes physicians to issue a prescription to end the lives of their patients who have been diagnosed with a terminal illness, are expected to die within six months, and have requested their physicians to help them do so. While the legislation does not require physicians to issue the prescription, it does require them to transfer a patient’s medical records to another physician who has agreed to prescribe the lethal medication.

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The Medical Aid in Dying Act goes even further, concluding that its passage serves the public’s interests, even as it endorses the “right of a qualified terminally ill patient …to obtain medication that the patient may choose to self-administer in order to bring about the patient’s humane and dignified death.”

The info is here.

Is there a right to die?

Eric Mathison
Baylor Medical College of Medicine Blog
Originally posted May 31, 2019

How people think about death is undergoing a major transformation in the United States. In the past decade, there has been a significant rise in assisted dying legalization, and more states are likely to legalize it soon.

People are adapting to a healthcare system that is adept at keeping people alive, but struggles when aggressive treatment is no longer best for the patient. Many people have concluded, after witnessing a loved one suffer through a prolonged dying process, that they don’t want that kind of death for themselves.

Public support for assisted dying is high. Gallup has tracked Americans’ support for it since 1951. The most recent survey, from 2017, found that 73% of Americans support legalization. Eighty-one percent of Democrats and 67% of Republicans support it, making this a popular policy regardless of political affiliation.

The effect has been a recent surge of states passing assisted dying legislation. New Jersey passed legislation in April, meaning seven states (plus the District of Columbia) now allow it. In addition to New Jersey, California, Colorado, Hawaii, and D.C. all passed legislation in the past three years, and seventeen states are considering legislation this year. Currently, around 20% of Americans live in states where assisted dying is legal.

The info is here.

Thursday, October 10, 2019

Moral Distress and Moral Strength Among Clinicians in Health Care Systems: A Call for Research

Connie M. Ulrich and Christine Grady
NAM Perspectives. 
https://doi.org/10.31478/201909c


Here is an excerpt:

Evidence shows that dissatisfaction and wanting to leave one’s job—and the profession altogether—often follow morally distressing encounters. Ethics education that builds cognitive and communication skills, teaches clinicians ethical concepts, and helps them gain communication skills and confidence may be essential in building moral strength. One study found, for example, that among practicing nurses and social workers, those with the least ethics education were also the least confident, the least likely to use ethics resources (if available), and the least likely to act on their ethical concerns. In this national study, as many as 23 percent of nurses reported having had no ethics education at all. But the question remains—is ethics education enough?

Many factors likely support or hinder a clinician’s capacity and willingness to act with moral strength. More research is needed to investigate how interdisciplinary ethics education and institutional resources can help nurses, physicians, and others voice their ethical concerns, help them agree on morally acceptable actions, and support their capacity and propensity to act with moral strength and confidence. Research on moral distress and ethical concerns in everyday clinical practice can begin to build a knowledge base that will inform clinical training—in both educational and health care institutions—and that will help create organizational structures and processes to prepare and support clinicians to encounter potentially distressing situations with moral strength. Research can help tease out what is important and predictive for taking (or not taking) ethical action in morally distressing circumstances. This knowledge would be useful for designing strategies to support clinician well-being. Indeed, studies should focus on the influences that affect clinicians’ ability and willingness to become involved or take ownership of ethically-laden patient care issues, and their level of confidence in doing so.

Our illusory sense of agency has a deeply important social purpose

<p>French captain Zinedine Zidane is sent off during the 2006 World Cup final in Germany. <em>Photo by Shaun Botterill/Getty</em></p>Chris Frith
aeon.com
Originally published September 22, 2019

Here are two excerpts:

We humans like to think of ourselves as mindful creatures. We have a vivid awareness of our subjective experience and a sense that we can choose how to act – in other words, that our conscious states are what cause our behaviour. Afterwards, if we want to, we might explain what we’ve done and why. But the way we justify our actions is fundamentally different from deciding what to do in the first place.

Or is it? Most of the time our perception of conscious control is an illusion. Many neuroscientific and psychological studies confirm that the brain’s ‘automatic pilot’ is usually in the driving seat, with little or no need for ‘us’ to be aware of what’s going on. Strangely, though, in these situations we retain an intense feeling that we’re in control of what we’re doing, what can be called a sense of agency. So where does this feeling come from?

It certainly doesn’t come from having access to the brain processes that underlie our actions. After all, I have no insight into the electrochemical particulars of how my nerves are firing or how neurotransmitters are coursing through my brain and bloodstream. Instead, our experience of agency seems to come from inferences we make about the causes of our actions, based on crude sensory data. And, as with any kind of perception based on inference, our experience can be tricked.

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These observations point to a fundamental paradox about consciousness. We have the strong impression that we choose when we do and don’t act and, as a consequence, we hold people responsible for their actions. Yet many of the ways we encounter the world don’t require any real conscious processing, and our feeling of agency can be deeply misleading.

If our experience of action doesn’t really affect what we do in the moment, then what is it for? Why have it? Contrary to what many people believe, I think agency is only relevant to what happens after we act – when we try to justify and explain ourselves to each other.

The info is here.

Wednesday, October 9, 2019

Whistle-blowers act out of a sense of morality

Alice Walton
review.chicagobooth.edu
Originally posted September 16, 2019

Here is an excerpt:

To understand the factors that predict the likelihood of whistle-blowing, the researchers analyzed data from more than 42,000 participants in the ongoing Merit Principles Survey, which has polled US government employees since 1979, and which covers whistle-blowing. Respondents answer questions about their past experiences with unethical behavior, the approaches they’d take in dealing with future unethical behavior, and their personal characteristics, including their concern for others and their feelings about their organizations.

Concern for others was the strongest predictor of whistle-blowing, the researchers find. This was true both of people who had already blown the whistle on bad behavior and of people who expected they might in the future.

Loyalty to an immediate community—or ingroup, in psychological terms—was also linked to whistle-blowing, but in an inverse way. “The greater people’s concern for loyalty, the less likely they were to blow the whistle,” write the researchers. 

Organizational factors—such as people’s perceptions about their employer, their concern for their job, and their level of motivation or engagement—were largely unconnected to whether people spoke up. The only ones that appeared to matter were how fair people perceived their organization to be, as well as the extent to which the organization educated its employees about ways to expose bad behavior and the rights of whistle-blowers. The data suggest these two factors were linked to whether whistle-blowers opted to address the unethical behavior through internal or external avenues. 

The info is here.

Moral and religious convictions: Are they the same or different things?

Skitka LJ, Hanson BE, Washburn AN, Mueller AB (2018)
PLoS ONE 13(6): e0199311.
https://doi.org/10.1371/journal.pone.0199311

Abstract

People often assume that moral and religious convictions are functionally the same thing. But are they? We report on 19 studies (N = 12,284) that tested whether people’s perceptions that their attitudes are reflections of their moral and religious convictions across 30 different issues were functionally the same (the equivalence hypothesis) or different constructs (the distinct constructs hypothesis), and whether the relationship between these constructs was conditional on political orientation (the political asymmetry hypothesis). Seven of these studies (N = 5,561, and 22 issues) also had data that allowed us to test whether moral and religious conviction are only closely related for those who are more rather than less religious (the secularization hypothesis), and a narrower form of the political asymmetry and secularization hypotheses, that is, that people’s moral and religious convictions may be tightly connected constructs only for religious conservatives. Meta-analytic tests of each of these hypotheses yielded weak support for the secularization hypothesis, no support for the equivalence or political asymmetry hypotheses, and the strongest support for the distinct constructs hypothesis.

From the Discussion

People’s lay theories often confound these constructs: If something is perceived as religious, it will also be perceived as moral (and vice versa). Contrary to both people’s lay theories and various scholarly theories of religion, however, we found that the degree to which people perceive a given attitude as a moral or religious conviction is largely orthogonal, sharing only on average 14% common variance.

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Religious and moral conviction were more strongly related to each other among the religious than the non-religious for 59% of the issues we examined, a finding consistent with the secularization hypothesis. That said, the effect size in support of the secularization hypothesis was very small; the interaction of religiosity and religious conviction only explained a little more than 1% of the variance in moral conviction overall. Taken together, the overwhelming evidence therefore seems most consistent with the distinct constructs hypothesis: Moral and religious convictions are largely independent constructs.

Tuesday, October 8, 2019

A Social Identity Approach to Engaging Christians in the Issue of Climate Change

Goldberg, M. H., Gustafson, A., Ballew, M. T.,
Rosenthal, S. A., & Leiserowitz, A.
(2019). Science Communication, 
41(4), 442–463.
https://doi.org/10.1177/1075547019860847

Abstract

Using two nationally representative surveys (total N = 2,544) and two experiments (total N = 1,620), we investigate a social identity approach to engaging Christians in the issue of climate change. Results show Christian Americans say “protecting God’s creation” is a top reason for wanting to reduce global warming. An exploratory experiment and a preregistered replication tested a “stewardship frame” message with Christian Americans and found significant increases in pro-environmental and climate change beliefs, which were explained by increases in viewing environmental protection as a moral and religious issue, and perceptions that other Christians care about environmental protection.

From the Discussion:

Two studies using large diverse samples demonstrate that a social identity approach to engaging Christians in the issue of climate change is a promising strategy. In Study 1, in a combined sample of two nationally representative waves of survey data, we found that “protect God’s creation” is one of the most important motivations Christians report for wanting to mitigate global warming. This is important because it indicates that many Americans, and especially Christians, are willing to view climate change through a religious lens, and that messages that frame climate change as a religious issue could encourage greater engagement in the issue among this population.

Greta Thunberg To U.S.: 'You Have A Moral Responsibility' On Climate Change

Bill Chappell and Ailsa Chang
NPR.org
Originally published September 13, 2019

Greta Thunberg led a protest at the White House on Friday. But she wasn't looking to go inside — "I don't want to meet with people who don't accept the science," she says.

The young Swedish activist joined a large crowd of protesters who had gathered outside, calling for immediate action to help the environment and reverse an alarming warming trend in average global temperatures.

She says her message for President Trump is the same thing she tells other politicians: Listen to science, and take responsibility.

Thunberg, 16, arrived in the U.S. last week after sailing across the Atlantic to avoid the carbon emissions from jet travel. She plans to spend nearly a week in Washington, D.C. — but she doesn't plan to meet with anyone from the Trump administration during that time.

"I haven't been invited to do that yet. And honestly I don't want to do that," Thunberg tells NPR's Ailsa Chang. If people in the White House who reject climate change want to change their minds, she says, they should rely on scientists and professionals to do that.

But Thunberg also believes the U.S. has an "incredibly important" role to play in fighting climate change.

"You are such a big country," she says. "In Sweden, when we demand politicians to do something, they say, 'It doesn't matter what we do — because just look at the U.S.'

The info is here.