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, February 15, 2020

Influencing the physiology and decisions of groups: Physiological linkage during group decision-making

Related imageThorson, K. R., and others.
(2020). Group Processes & Intergroup Relations. 
https://doi.org/10.1177/1368430219890909

Abstract

Many of the most important decisions in our society are made within groups, yet we know little about how the physiological responses of group members predict the decisions that groups make. In the current work, we examine whether physiological linkage from “senders” to “receivers”—which occurs when a sender’s physiological response predicts a receiver’s physiological response—is associated with senders’ success at persuading the group to make a decision in their favor. We also examine whether experimentally manipulated status—an important predictor of social behavior—is associated with physiological linkage. In groups of 5, we randomly assigned 1 person to be high status, 1 low status, and 3 middle status. Groups completed a collaborative decision-making task that required them to come to a consensus on a decision to hire 1 of 5 firms. Unbeknownst to the 3 middle-status members, high- and low-status members surreptitiously were told to each argue for different firms. We measured cardiac interbeat intervals of all group members throughout the decision-making process to assess physiological linkage. We found that the more receivers were physiologically linked to senders, the more likely groups were to make a decision in favor of the senders. We did not find that people were physiologically linked to their group members as a function of their fellow group members’ status. This work identifies physiological linkage as a novel correlate of persuasion and highlights the need to understand the relationship between group members’ physiological responses during group decision-making.

Friday, February 14, 2020

The Moral Self and Moral Duties

J. Everett, J. Skorburg, and J. Savulescu
PsyArXiv
Created on 6 Jan 20

Abstract

Recent research has begun treating the perennial philosophical question, “what makes a person the same over time?” as an empirical question. A long tradition in philosophy holds that psychological continuity and connectedness of memories are at the heart of personal identity. More recent experimental work, following Strohminger & Nichols (2014), has suggested that persistence of moral character, more than memories, is perceived as essential for personal identity. While there is a growing body of evidence supporting these findings, a critique by Starmans & Bloom (2018) suggests that this research program conflates personal identity with mere similarity. To address this criticism, we explore how loss of someone’s morality or memories influence perceptions of identity change, and perceptions of moral duties towards the target of the change. We present participants with a classic ‘body switch’ thought experiment and after assessing perceptions of identity persistence, we present a moral dilemma, asking participants to imagine that one of the patients must die (Study 1) or be left alone in a care home for the rest of their life (Study 2). Our results highlight the importance of the continuity of moral character, suggesting lay intuitions are tracking (something like) personal identity, not just mere similarity.

The research is here.

Judgment and Decision Making

Baruch Fischhoff and Stephen B. Broomell
Annual Review of Psychology 
2020 71:1, 331-355

Abstract

The science of judgment and decision making involves three interrelated forms of research: analysis of the decisions people face, description of their natural responses, and interventions meant to help them do better. After briefly introducing the field's intellectual foundations, we review recent basic research into the three core elements of decision making: judgment, or how people predict the outcomes that will follow possible choices; preference, or how people weigh those outcomes; and choice, or how people combine judgments and preferences to reach a decision. We then review research into two potential sources of behavioral heterogeneity: individual differences in decision-making competence and developmental changes across the life span. Next, we illustrate applications intended to improve individual and organizational decision making in health, public policy, intelligence analysis, and risk management. We emphasize the potential value of coupling analytical and behavioral research and having basic and applied research inform one another.

The paper can be downloaded here.

Thursday, February 13, 2020

Groundbreaking Court Ruling Against Insurer Offers Hope in 2020

Katherine G. Kennedy
Psychiatric News
Originally posted 9 Jan 20

Here is an excerpt:

In his 106-page opinion, Judge Spero criticized UBH for using flawed, internally developed, and overly restrictive medical necessity guidelines that favored protecting the financial interests of UBH over medical treatment of its members.

“By a preponderance of the evidence,” Judge Spero wrote, “in each version of the Guidelines at issue in this case the defect is pervasive and results in a significantly narrower scope of coverage than is consistent with generally accepted standards of care.” His full decision can be accessed here.

As of this writing, we are still awaiting Judge Spero’s remedies order (a court-ordered directive that requires specific actions, such as reparations) against UBH. Following that determination, we will know what UBH will be required to do to compensate class members who suffered damages (that is, protracted illness or death) or their beneficiaries as a result of UBH’s denial of their coverage claims.

But waiting for the remedies order does not prevent us from looking for answers to critical questions like these:

  • Will Wit. v. UBH impact the insurance industry enough to catalyze widespread reforms in how utilization review guidelines are determined and used?
  • How will the 50 offices of state insurance commissioners respond? Will these regulators mandate the use of clinical coverage guidelines that reflect the findings in Wit. v. UBH? Will they tighten their oversight with updated regulations and enforcement actions?


The info is here.

FDA and NIH let clinical trial sponsors keep results secret and break the law

Charles Piller
sciencemag.org
Originally posted 13 Jan 20

For 20 years, the U.S. government has urged companies, universities, and other institutions that conduct clinical trials to record their results in a federal database, so doctors and patients can see whether new treatments are safe and effective. Few trial sponsors have consistently done so, even after a 2007 law made posting mandatory for many trials registered in the database. In 2017, the National Institutes of Health (NIH) and the Food and Drug Administration (FDA) tried again, enacting a long-awaited “final rule” to clarify the law’s expectations and penalties for failing to disclose trial results. The rule took full effect 2 years ago, on 18 January 2018, giving trial sponsors ample time to comply. But a Science investigation shows that many still ignore the requirement, while federal officials do little or nothing to enforce the law.

(cut)

Contacted for comment, none of the institutions disputed the findings of this investigation. In all 4768 trials Science checked, sponsors violated the reporting law more than 55% of the time. And in hundreds of cases where the sponsors got credit for reporting trial results, they have yet to be publicly posted because of quality lapses flagged by ClinicalTrials.gov staff.

The info is here.

Wednesday, February 12, 2020

Judge holds Pa. psychologist in contempt, calls her defiance ‘extraordinary’ in trucker’s case

John Beague
PennLive.com
Originally 18 Jan 20

A federal judge has held a Sunbury psychologist in contempt and sanctioned her $8,288 for failing to comply with a subpoena and a court order in a civil case stemming from a 2016 traffic crash.

U.S. Middle District Judge Matthew W. Brann, in an opinion issued Friday, said he has never encountered the “obstinance” displayed by Donna Pinter of Psychological Services Clinic Inc.

He called Pinter’s defiance “extraordinary” and pointed out that she never objected to the validity of the subpoena or court order and did not provide an adequate excuse.

“She forced the parties and this court to waste significant and limited resources litigating these motions and convening two hearings for what should have been a routine document production,” he wrote.

The defendants sought information about Kenneth Kerlin of Middleburg from Pinter because she has treated him for years and in his suit he claims the crash, which involved two tractor-trailers, has caused him mental suffering.

The info is here.

Empirical Work in Moral Psychology

Joshua May
Routledge Encyclopedia of Philosophy
Taylor and Francis
Originally published in 2017

Abstract

How do we form our moral judgments, and how do they influence behaviour? What ultimately motivates kind versus malicious action? Moral psychology is the interdisciplinary study of such questions about the mental lives of moral agents, including moral thought, feeling, reasoning and motivation. While these questions can be studied solely from the armchair or using only empirical tools, researchers in various disciplines, from biology to neuroscience to philosophy, can address them in tandem. Some key topics in this respect revolve around moral cognition and motivation, such as moral responsibility, altruism, the structure of moral motivation, weakness of will, and moral intuitions. Of course there are other important topics as well, including emotions, character, moral development, self-deception, addiction, well-being, and the evolution of moral capacities.

Some of the primary objects of study in moral psychology are the processes driving moral action. For example, we think of ourselves as possessing free will, as being responsible for what we do; as capable of self-control; and as capable of genuine concern for the welfare of others. Such claims can be tested by empirical methods to some extent in at least two ways. First, we can determine what in fact our ordinary thinking is. While many philosophers investigate this through rigorous reflection on concepts, we can also use the empirical methods of the social sciences. Second, we can investigate empirically whether our ordinary thinking is correct or illusory. For example, we can check the empirical adequacy of philosophical theories, assessing directly any claims made about how we think, feel, and behave

Understanding the psychology of moral individuals is certainly interesting in its own right, but it also often has direct implications for other areas of ethics, such as metaethics and normative ethics. For instance, determining the role of reason versus sentiment in moral judgment and motivation can shed light on whether moral judgments are cognitive, and perhaps whether morality itself is in some sense objective. Similarly, evaluating moral theories, such as deontology and utilitarianism, often relies on intuitive judgments about what one ought to do in various hypothetical cases. Empirical research can again serve as an additional tool to determine what exactly our intuitions are and which psychological processes generate them, contributing to a rigorous evaluation of the warrant of moral intuitions.

The info is here.

Tuesday, February 11, 2020

How to build ethical AI

Carolyn Herzog
thehill.com
Originally posted 18 Jan 20

Here is an excerpt:

Any standard-setting in this field must be rooted in the understanding that data is the lifeblood of AI. The continual input of information is what fuels machine learning, and the most powerful AI tools require massive amounts of it. This of course raises issues of how that data is being collected, how it is being used, and how it is being safeguarded.

One of the most difficult questions we must address is how to overcome bias, particularly the unintentional kind. Let’s consider one potential application for AI: criminal justice. By removing prejudices that contribute to racial and demographic disparities, we can create systems that produce more uniform sentencing standards. Yet, programming such a system still requires weighting countless factors to determine appropriate outcomes. It is a human who must program the AI, and a person’s worldview will shape how they program machines to learn. That’s just one reason why enterprises developing AI must consider workforce diversity and put in place best practices and control for both intentional and inherent bias.

This leads back to transparency.

A computer can make a highly complex decision in an instant, but will we have confidence that it’s making a just one?

Whether a machine is determining a jail sentence, or approving a loan, or deciding who is admitted to a college, how do we explain how those choices were made? And how do we make sure the factors that went into that algorithm are understandable for the average person?

The info is here.

The Americans dying because they can't afford medical care

Michael Sainato
theguardian.com
Originally posted 7 Jan 2020

Here is an excerpt:

Finley is one of millions of Americans who avoid medical treatment due to the costs every year.

A December 2019 poll conducted by Gallup found 25% of Americans say they or a family member have delayed medical treatment for a serious illness due to the costs of care, and an additional 8% report delaying medical treatment for less serious illnesses. A study conducted by the American Cancer Society in May 2019 found 56% of adults in America report having at least one medical financial hardship, and researchers warned the problem is likely to worsen unless action is taken.

Dr Robin Yabroff, lead author of the American Cancer Society study, said last month’s Gallup poll finding that 25% of Americans were delaying care was “consistent with numerous other studies documenting that many in the United States have trouble paying medical bills”.

US spends the most on healthcare

Despite millions of Americans delaying medical treatment due to the costs, the US still spends the most on healthcare of any developed nation in the world, while covering fewer people and achieving worse overall health outcomes. A 2017 analysis found the United States ranks 24th globally in achieving health goals set by the United Nations. In 2018, $3.65tn was spent on healthcare in the United States, and these costs are projected to grow at an annual rate of 5.5% over the next decade.

The info is here.