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

Tuesday, March 10, 2020

Three Unresolved Issues in Human Morality

Jerome Kagan
Perspectives on Psychological Science
First Published March 28, 2018

Abstract

This article discusses three major, but related, controversies surrounding the idea of morality. Is the complete pattern of features defining human morality unique to this species? How context dependent are moral beliefs and the emotions that often follow a violation of a moral standard? What developmental sequence establishes a moral code? This essay suggests that human morality rests on a combination of cognitive and emotional processes that are missing from the repertoires of other species. Second, the moral evaluation of every behavior, whether by self or others, depends on the agent, the action, the target of the behavior, and the context. The ontogeny of morality, which begins with processes that apes possess but adds language, inference, shame, and guilt, implies that humans are capable of experiencing blends of thoughts and feelings for which no semantic term exists. As a result, conclusions about a person’s moral emotions based only on questionnaires or interviews are limited to this evidence.

From the Summary

The human moral sense appears to contain some features not found in any other animal. The judgment of a behavior as moral or immoral, by self or community, depends on the agent, the action, and the setting. The development of a moral code involves changes in both cognitive and affective processes that are the result of maturation and experience. The ideas in this essay have pragmatic implications for psychological research. If most humans want others to regard them as moral agents, and, therefore, good persons, their answers to questionnaires or to interviewers as well as behaviors in laboratories will tend to conform to their understanding of what the examiner regards as the society’s values. That is why investigators should try to gather evidence on the behaviors that their participants exhibit in their usual settings.

The article is here.

The Perils of “Survivorship Bias”

Katy Milkman
Scientific American
Originally posted 11 Feb 20

Here is an excerpt:

My colleagues and I, we’ve been spending a lot of time looking at medical decision-making. Say you walk into an emergency room, and you might or might not be having a heart attack. If I test you, I learn whether I’m making a good decision or not. But if I say, “It’s unlikely, so I’ll just send her home,” it’s almost the opposite of survivorship bias. I never get to learn if I made a good decision. And this is supercommon, not just in medicine but in every profession.

Similarly, there was a work done that showed that people who had car accidents were also more likely to have cancer. It was kind of a puzzle until you think, “Wait, who do we measure cancer in?” We don’t measure cancer in everybody. We measure cancer in people who have been tested. And who do we test? We test people who are in hospitals. So someone goes to the hospital for a car accident, and then I do an MRI and find a tumor. And now that leads to car accidents appearing to elevate the level of tumors. So anything that gets you into hospitals raises your “cancer rate,” but that’s not your real cancer rate.

That’s one of my favorite examples, because it really illustrates how even with something like cancer, we’re not actually measuring it without selection bias, because we only measure it in a subset of the population.

How can people avoid falling prey to these kinds of biases?

Look at your life and where you get feedback and ask, “Is that feedback selected, or am I getting unvarnished feedback?”

Whatever the claim—it could be “I’m good at blank” or “Wow, we have a high hit rate” or any sort of assessment—then you think about where the data comes from. Maybe it’s your past successes. And this is the key: Think about what the process that generated the data is. What are all the other things that could have happened that might have led me to not measure it? In other words, if I say, “I’m great at interviewing,” you say, “Okay. Well, what data are you basing that on?” “Well, my hires are great.” You can counter with, “Have you considered the people who you have not hired?”

The info is here.

Monday, March 9, 2020

The dangerous veneer of ‘science’

Regini Rini
Times Literary Supplement
Originally posted Feb 20

"Race science” seems to be the hideous new trend of 2020. Last month, an article in the journal Philosophical Psychology calling for greater investigation of purported genetic bases for racial IQ differences became the focus of intense academic controversy. Then came a new book, Human Diversity, from Charles Murray, prompting the New York Times columnist Jamelle Bouie to tweet: “i guess we’re gonna spend february arguing with phrenologists”. And then just this week, a twenty-seven-year-old consultant to the British government quickly resigned following media reports of his apparent musings on eugenics.

What’s going on? Why are we suddenly talking about this nonsense again? Donald Trump, and the winks he tosses to torch-wielding “blood and soil” marchers, may have something to do with it. Clearly there is a market for white coats who cater to white hoods. But the “race science” racket is growing, and we needn’t assume that all its practitioners have such transparently bigoted motives. Rather, I suspect that some are in it for the iconoclastic thrill of prodding at bien pensant pieties from behind the intellectual shield of capital-S Science.

There has always been a certain sort of mind that delights in saying whatever is verboten, from the Marquis de Sade to Christopher Hitchens. The writer George Packer worries that, in the high-stakes moral atmosphere of the Trump era, we no longer have cultural space for such fearless exploration of opinion. But I think this gets things exactly backwards. Trumpism is partly a result of the fact that it is now much easier to acquire an audience for heterodoxy. You don’t have to be a gifted essayist; you need only a Twitter account and lack of moral inhibition. Thoughtful iconoclasts aren’t silenced, they’re merely lost amid the din of so many icons being artlessly shattered.

The info is here.

The Role of Passing Time in Decision-Making

N. Evans, G. Hawkins, & S. Brown
PsyArXiv
Last edited 1 April 19

Abstract

Theories of perceptual decision-making have been dominated by the idea that evidence accumulates in favor of different alternatives until some fixed threshold amount is reached, which triggers a decision. Recent theories have suggested that these thresholds may not be fixed during each decision, but change as time passes. These collapsing thresholds can improve performance in particular decision environments, but reviews of data from typical decision-making paradigms have failed to support collapsing thresholds. We designed three experiments to test collapsing threshold assumptions in decision environments specifically tailored to make them optimal. An emphasis on decision speed encouraged the adoption of collapsing thresholds – most strongly through the use of response deadlines, but also through instruction to a lesser extent – but setting an explicit goal of reward rate optimality through both instructions and task design did not. Our results provide a new explanation for previous findings regarding decision-making differences between humans and non-human primates.

The research is here.

Sunday, March 8, 2020

Humility and self-doubt are hallmarks of a good therapist

<p><em>Photo by Kelly Sikema/Unsplash</em></p>Helene Nissen-Lie
aeon.co
Originally posted 5 Feb 20

Here is an excerpt:

However, therapist humility on its own is not sufficient for therapy to be effective. In our latest study, we assessed how much therapists treat themselves in a kind and forgiving manner in their personal lives (ie, report more ‘self-affiliation’) and their perceptions of themselves professionally. We anticipated that therapists’ level of personal self-affiliation would enhance the effect that professional self-doubt has on therapeutic change. Our hypothesis was supported: therapists who reported more self-doubt in their work alleviated client distress more if they also reported being kind to themselves outside of work (in contrast, therapists who scored low on self-doubt and high on self-affiliation contributed to the least change).

We interpreted this finding to imply that a benign self-critical stance in a therapist is beneficial, but that self-care and forgiveness without reflective self-criticism is not. The combination of self-affiliation and professional self-doubt seems to pave the way for an open, self-reflective attitude that allows psychotherapists to respect the complexity of their work, and, when needed, to correct the therapeutic course to help clients more effectively.

What does all this mean? At a time when people tend to think that their value is based on how confident they are and that they must ‘sell themselves’ in every situation, the finding that therapist humility is an underrated virtue and a paradoxical ingredient of expertise might be a relief.

The info is here.

Saturday, March 7, 2020

Ethical guidelines for social justice in psychology

Hailes, H. and others
Professional Psychology:
Research and Practice

Abstract

As the field of psychology increasingly recognizes the importance of engaging in work that advances social justice and as social justice-focused training and practice in the field grows, psychologists need ethical guidelines for this work. The American Psychological Association’s ethical principles include “justice” as a core principle but do not expand extensively upon its implications. This article provides a proposed set of ethical guidelines for social justice work in psychology. Within the framework of 3 domains of justice—interactional (about relational dynamics), distributive (about provision for all), and procedural (about just processes) justice—this article outlines 7 guidelines for social justice ethics: (1) reflecting critically on relational power dynamics; (2) mitigating relational power dynamics; (3) focusing on empowerment and strengths-based approaches; (4) focusing energy and resources on the priorities of marginalized communities; (5) contributing time, funding, and effort to preventive work; (6) engaging with social systems; and (7) raising awareness about system impacts on individual and community well-being. Vignettes of relevant ethical dilemmas are presented and implications for practice are discussed.

This article explores the need for a set of ethical standards to guide psychologists’ social justice-oriented work. It conceptualizes social justice as having three components, focused on relational dynamics, provision for all, and just processes. Additionally, it outlines and provides examples of seven proposed standards for social justice ethics in psychology.

The article is here.

Friday, March 6, 2020

Are Insects Capable of Moral Behavior?

Livia Gershon
daily.jstor.org
Originally published 6 Feb 20

Are insects conscious, capable of a subjective experience of the world? And, if so, can they be moral actors, or victims of immoral acts (like, say, being flushed down the toilet)? These questions interest modern scientists. And, as Jeanette Samyn writes, they also mattered to nineteenth-century naturalists who asked questions about behavior and morality in relation to the nonhuman world.

Writing in the 1810s and 1820s, British entomologists William Kirby and William Spence presented parasites as tools of God. To them, lice represented a punishment for both “personal uncleanliness” and for “oppression and tyranny.”

Still, Kirby, Spence, and other biologists wrestled with whether insects could be moral actors. Were they driven purely by instinct or capable of some sort of reason? And how could their more disgusting behaviors be reconciled with a universe ordered by God? Charles Darwin wrote that it was difficult to believe “that a beneficent & omnipotent God would have designedly created the Ichneumonidae with the express intention of their feeding within the living bodies of caterpillars.” Instead, he wrote, he preferred to “look at everything as resulting from designed laws, with the details, whether good or bad, left to the working out of what we may call chance.” “Not,” he added somewhat glumly, “that this at all satisfies me.”

Other naturalists presented insects as moral beings. Some chose to focus on a few charismatic species—notably bees, which had long been admired as sociable, productive creatures who were helpful to humans. But Samyn points to a different take on the value of insect life presented by Louis Figuier, a French writer who interpreted science for a popular audience.

The info is here.

Transgender and Intersex Kids Must Have a Voice in Health Care Decisions

Scott Nass
thenation.com
Originally posted 13 Feb 20

Here is an excerpt:

We physicians are not allowed to take critical care away from patients, nor to force interventions on them, just because their bodies and needs don’t fit our personal expectations of “normal.” That’s not a part of our oath. Prioritizing patients means focusing on what they say they need, supporting each patient and their family in age-appropriate ways. The answer is very simple: Individuals must take the lead in making decisions about their own bodies.

Just because individuals are minors now does not mean they won’t have wishes for their bodies in the future. Transgender and intersex youth grow up. When they are denied their own choices, families bear the resulting stress and trauma.

If you don’t know any transgender or intersex kids, it may feel easy to shrug this off. But this is about more than just a few bad bills. Intersex and transgender children’s bodies are being used to uphold regressive ideas about gender’s being based on anatomy and fixed at birth, with medicine used to enforce rather than affirm.

It’s clear to me, as a physician who helps intersex and transgender children live healthy lives, that those who supported the South Dakota bill are putting youth at risk. Nearly 45 percent of transgender youth considered suicide in 2017, according to the Trevor Project. Those numbers are highest when children are not allowed to affirm their gender. Of intersex children who had infant clitoral surgery, 39 percent could not achieve orgasm as adults, compared to 0 percent in a control group. Many families are never told about these types of risks.

The info is here.

Thursday, March 5, 2020

Ethical concerns with online direct-to-consumer pharmaceutical companies

Curtis H, Milner J
Journal of Medical Ethics 
2020;46:168-171.

Abstract

In recent years, online direct-to-consumer pharmaceutical companies have been created as an alternative method for individuals to get prescription medications. While these companies have noble aims to provide easier, more cost-effective access to medication, the fact that these companies both issue prescriptions (via entirely online medical reviews that can have no direct contact between physician and patient) as well as distribute and ship medications creates multiple ethical concerns. This paper aims to explore two in particular. First, this model creates conflicts of interest for the physicians hired by these companies to write prescriptions. Second, the lack of direct contact from physicians may be harmful to prospective patients. After analysing these issues, this paper argues that there ought to be further consideration for regulation and oversight for these companies.

The info is here.