The Answer to a COVID-19 Vaccine May Lie in Our Genes, But ...

Ifeoma Ajunwa & Forrest Briscoe
Scientific American
Originally posted 13 May 2020

Here is an excerpt:

Although the rationale for expanded genetic testing is obviously meant for the greater good, such testing could also bring with it a host of privacy and economic harms. In the past, genetic testing has also been associated with employment discrimination. Even before the current crisis, companies like 23andMe and Ancestry assembled and started operating their own private long-term large-scale databases of U.S. citizens’ genetic and health data. 23andMe and Ancestry recently announced they would use their databases to identify genetic factors that predict COVID-19 susceptibility.

Other companies are growing similar databases, for a range of purposes. And the NIH’s AllofUs program is constructing a genetic database, owned by the federal government, in which data from one million people will be used to study various diseases. These new developments indicate an urgent need for appropriate genetic data governance.

Leaders from the biomedical research community recently proposed a voluntary code of conduct for organizations constructing and sharing genetic databases. We believe that the public has a right to understand the risks of genetic databases and a right to have a say in how those databases will be governed. To ascertain public expectations about genetic data governance, we surveyed over two thousand (n=2,020) individuals who altogether are representative of the general U.S. population. After educating respondents about the key benefits and risks associated with DNA databases—using information from recent mainstream news reports—we asked how willing they would be to provide their DNA data for such a database.

The info is here.

Self-Nudging and the Citizen Choice Architect

Samuli Reijula, Ralph Hertwig.
Behavioural Public Policy, 2020
DOI: 10.1017/bpp.2020.5

Abstract

This article argues that nudges can often be turned into self-nudges: empowering interventions that enable people to design and structure their own decision environments—that is, to act as citizen choice architects. Self-nudging applies insights from behavioral science in a way that is practicable and cost-effective but that sidesteps concerns about paternalism or manipulation. It has the potential to expand the scope of application of behavioral insights from the public to the personal sphere (e.g., homes, offices, families). It is a tool for reducing failures of self-control and enhancing personal autonomy; specifically, self-nudging can mean designing one’s proximate choice architecture to alleviate the effects of self-control problems, engaging in education to understand the nature and causes of self-control problems, and employing simple educational nudges to improve goal attainment in various domains. It can even mean self-paternalistic interventions such as winnowing down one’s choice set by, for instance, removing options.  Policy makers could promote self-nudging by sharing knowledge about nudges and how they work. The ultimate goal of the self-nudging approach is to enable citizen choice architects’ efficient self-governance, where reasonable, and the self-determined arbitration of conflicts between their mutually exclusive goals and preferences.

From the Conclusion:

Commercial choice architects have become proficient in hijacking people’s attention and desires (see, e.g., Nestle 2013; Nestle 2015; Cross and Proctor 2014; Wu 2017), making it difficult for consumers to exercise agency and freedom of choice. Even in the best of circumstances, the potential for public choice architects to nudge people toward better choices in their personal and proximate choice environments is limited. Against this background, we suggest that policy makers should consider the possibility of empowering individuals to make strategic changes in their proximate choice architecture. There is no reason why citizens should not be informed about nudges that can be turned into self-nudges and, more generally, about the design principles of choice environments (e.g., defaults, framing, cognitive accessibility). We suggest that self-nudging is an untapped resource that sidesteps various ethical and practical problems associated with nudging and can empower people to make better everyday choices. This does not mean that regulation or nudging should be replaced by self-nudging; indeed, self-nudging can benefit enormously from the ingenuity of the nudging approach and the evidence accumulating on it. But, as the adage goes, give someone a fish, and you need them for a day. Teach someone to fish, and you feed them for a lifetime. We believe that sharing  behavioral insights from psychology and behavioral economics will provide citizens with a the citizen choice architect means for taking back power, giving them more control over the design of their proximate choice environments–in other words, qualifying them as citizen choice architects.

The article is here.

Humans are complicated—do we need behavioral science to get through this?

Cathleen O'Grady
Ars Technica
Originally published 16 May 20

Here is an excerpt:

Leaning on the evidence

If humans didn’t insist on being quite so messily human, pandemic response would be much simpler. People would stay physically separated whenever possible; leaders would be proactive and responsive to evidence; our fight could be concentrated on the biomedical tools we so urgently need. The problem is that our maddening, imperfect humanity gets in the way at every turn, and getting around those imperfections demands that we understand the human behavior underlying them.

It's also clear that we need to understand the differences between groups of people to get a handle on the pandemic. Speculation has been rampant about how cultural differences might influence what sort of responses are palatable. And some groups are suffering disproportionately: death rates are higher among African-American and Latinx communities in the US, while a large analysis from the UK found that black, minority ethnic, and poorer people are at higher risk of death—our social inequalities, housing, transport, and food systems all play a role in shaping the crisis. We can’t extricate people and our complicated human behavior and society from the pandemic: they are one and the same.

In their paper, Van Bavel, Willer and their group of behavioral research proponents point to studies from fields like public health, sociology and psychology. They cover work on cultural differences, social inequality, mental health, and more, pulling out suggestions for how the research could be useful for policymakers and community leaders.

Those recommendations are pretty intuitive. For effective communications, it could be helpful to lean on sources that carry weight in different communities, like religious leaders, they suggest. And public health messaging that emphasizes protecting others—rather than fixating on just protecting oneself—tends to be persuasive, the proponents argue.

But not everyone is convinced that it would necessarily be a good idea to act on the recommendations. “Many of the topics surveyed are relevant,” write psychologist Hans IJzerman and a team of critics in their draft. The team's concern isn’t the relevance of the research; it’s how robust that research is. If there are critical flaws in the supporting data, then applying these lessons on a broad scale could be worse than useless—it could be actively harmful.

The info is here.

When Is “Gay Panic” Accepted? Exploring Juror Characteristics and Case Type as Predictors of a Successful Gay Panic Defense

Michalski, N. D., & Nunez, N. (2020).
Journal of Interpersonal Violence. 
https://doi.org/10.1177/0886260520912595

Abstract

“Gay panic” refers to a situation in which a heterosexual individual charged with a violent crime against a homosexual individual claims they lost control and reacted violently because of an unwanted sexual advance that was made upon them. This justification for a violent crime presented by the defendant in the form of a provocation defense is used as an effort to mitigate the charges brought against him. There has been relatively little research conducted concerning this defense strategy and the variables that might predict when the defense is likely to be successful in achieving a lesser sentence for the defendant. This study utilized 249 mock jurors to assess the effects of case type (assault or homicide) and juror characteristics (homophobia, religious fundamentalism, and political orientation) on the success of the gay panic defense compared with a neutral provocation defense. Participant homophobia was found to be the driving force behind their willingness to accept the gay panic defense as legitimate. Higher levels of homophobia and religious fundamentalism were found to predict more leniency in verdict decisions when the gay panic defense was presented. This study furthers the understanding of decision making in cases involving the gay panic defense and highlights the need for more research to be conducted to help understand and combat LGBT (lesbian, gay, bisexual, and transgender) prejudice in the courtroom.

The research is here.

Ethical road map through the COVID-19 pandemic

Zoe Fritz and others
BMJ 2020; 369
doi: https://doi.org/10.1136/bmj.m2033

The covid-19 pandemic has created profound ethical challenges in health and social care, not only for current decisions about individuals but also for longer term and population level policy decisions. Already covid-19 has generated ethical questions about the prioritisation of treatment, protective equipment, and testing; the impact of covid-19 strategies on patients with other health conditions; the approaches taken to advance care planning and resuscitation decisions; and the crisis in care homes.

Ethical questions continue to multiply as the pandemic progresses and new evidence emerges, including how best to distribute any new vaccines and treatments; how best to respond to evidence that disease severity and mortality are substantially greater in ethnic minority populations; how to prioritise patients for care as medical services re-open; how to manage assessment of immunity and its implications; and how the health system should be configured to manage any future peaks in cases.

Science and values

The UK government repeatedly states that it is “following the science” by heeding the advice provided through the Scientific Advisory Group for Emergencies (SAGE). However, this implies that the science alone will tell us what to do. Not only does this rhetoric shift the responsibility for difficult decisions on to “the science”, it is also wrong. Science may provide evidence on which to base decisions, but our values will determine what we do with that evidence and how we select the evidence to use. It is disingenuous and misleading to imply that value-free science leads the way. Both science and policy are value laden.

Values questions are being addressed primarily by professional organisations, although the UK government has independent advice, for example, from the Moral and Ethical Advisory Group. Despite such efforts to plot an ethical path, the current approach is piecemeal, confusing, and risks needless duplication of effort. Concerns are mounting about a lack of transparency around the ethical agenda underpinning decisions, a lack of coordination, and the absence of clear national leadership.

The info is here.

Global health without justice or ethics

S Venkatapuram
Journal of Public Health
https://doi.org/10.1093/pubmed/fdaa001

The great promise at the start of the twenty-first century that Anglo-American philosophers would produce transformative theories and practical guidance for realizing global health equity and justice has largely gone unfulfilled. The publication of The Law of Peoples by John Rawls in 1999 formally inaugurated the emerging academic field of global justice philosophy.1 After 2000, numerous monographs, journal articles and conferences discussed global justice. And new academic associations, journals and research centres were established.

One remarkable aspect of the new field was that the stark inequalities in health across societies were often the starting concern. Despite our diverse philosophical and ethical views, reasonable people are likely to be morally troubled about the large inequalities in life expectancies between some sub-Saharan country X and the USA or another rich country. This initially shared moral intuition or indignation, then, motivated diverse arguments about what precisely is morally bad about global health inequalities and global poverty and the possible demands of justice. Some philosophers described what ‘our’ duties are or, indeed, are not, to help ‘those people over there’. Others minimized the distinction between us and them by arguing for theories of radical global equality, the arbitrariness of political borders and duties that follow from our complicity in transnational harms experienced in other countries.

Progress in global justice philosophy seemingly promised real-world progress in global health equity and justice, because health inequality was the foremost issue in philosophical debates on global inequality, poverty and claims of the ‘global poor’. At the same time, largely driven by HIV research, bioethics went global as it was exported alongside medical research to resource poor settings. Bioethicists also began to go beyond clinical and research settings to examine public health ethics, social inequalities in health and social determinants—from local conditions all the way to global institutions and processes. Nevertheless, as of 2020, it is difficult to identify any compelling conceptions of global justice or global health justice or to identify any significant philosophical contributions to the practical improvement of global health and inequalities. What happened?

The rest of the article is linked above.

Trust in Medical Scientists Has Grown in U.S.

C. Funk, B. Kennedy, & C. Johnson
Pew Research Center
Originally published 21 May 20

Americans’ confidence in medical scientists has grown since the coronavirus outbreak first began to upend life in the United States, as have perceptions that medical doctors hold very high ethical standards. And in their own estimation, most U.S. adults think the outbreak raises the importance of scientific developments.

Scientists have played a prominent role in advising government leaders and informing the public about the course of the pandemic, with doctors such as Anthony Fauci and Deborah Birx, among others, appearing at press conferences alongside President Donald Trump and other government officials.

But there are growing partisan divisions over the risk the novel coronavirus poses to public health, as well as public confidence in the scientific and medical community and the role such experts are playing in public policy.

Still, most Americans believe social distancing measures are helping at least some to slow the spread of the coronavirus disease, known as COVID-19. People see a mix of reasons behind new cases of infection, including limited testing, people not following social distancing measures and the nature of the disease itself.

These are among the key findings from a new national survey by Pew Research Center, conducted April 29 to May 5 among 10,957 U.S. adults, and a new analysis of a national survey conducted April 20 to 26 among 10,139 U.S. adults, both using the Center’s American Trends Panel.

Public confidence in medical scientists to act in the best interests of the public has gone up from 35% with a great deal of confidence before the outbreak to 43% in the Center’s April survey. Similarly, there is a modest uptick in public confidence in scientists, from 35% in 2019 to 39% today. (A random half of survey respondents rated their confidence in one of the two groups.)

The info is here.

'A coronavirus depression could be the great leveller'

Kyrill Hartog
The Guardian
Originally published 30 April 2020

Here is an excerpt:

So could the pandemic of our era, already considered the greatest global crisis since the second world war, turn out to be a great societal leveller?

Scheidel’s short answer is that the longer the pandemic wreaks havoc on the global economy, the greater the potential for radical equalising change. “It depends on how severe the crisis is going to be, how long it’s going to last and how much it’s ultimately going to interrupt supply chains.”

The pandemic has already exposed the limits of the market and highlighted the importance of effective state intervention and strong public healthcare provision. In the future this may well create a tolerance for higher and more progressive taxation. Governments have had to intervene to prop up businesses and jobs in ways that only months ago would have seemed unimaginable. The viability of a universal basic income — a dream for egalitarians worldwide — is once again part of the mainstream debate in many countries.

The response at EU level also shows a willingness for strong public intervention and an end to the fiscal restraint approach of the last decade — at least, temporarily.

As people start to believe in government intervention again, the post-corona political landscape may well provide fertile soil for reversing a situation where, since 1980, the richest 1% in the UK have tripled their share of household income and the wealth of the European top 1% grew twice as fast as the bottom 50%.

But Scheidel cautions that, while disasters are not uncommon, tectonic shifts are historical anomalies. In other words, it may take a disaster to usher in more equality, but not every disaster does.

The info is here.

Rebuilding the Economy Around Good Jobs

Zeynep Ton
Harvard Business Review
Originally posted 22 May 20

One thing we can predict: Customers who are struggling economically will be looking more than ever for good value. This will give the companies that start building a good jobs system a competitive advantage over those that don’t. After the financial crisis of 2008, Mercadona — Spain’s largest grocery chain and a model good jobs company — reduced prices for its hard-pressed customers by 10% while remaining profitable and gaining significant market share. Hard work and input from empowered front lines had a lot to do with it.

The pandemic is likely to accelerate the ongoing shakeup of U.S. retailing. The United States has 24.5 square feet of retail space per person versus 16.4 square feet in Canada and 4.5 square feet in Europe. This is almost certainly too much and the mediocre — the ones that don’t make their customers want to keep coming back — will not survive.

The pandemic is likely to speed up the adoption of new technologies. Although typically seen as a way to reduce headcount, adopting, scaling, and leveraging new technologies require a capable and motivated (even if smaller) workforce.

There is an alternative: A good jobs system that has already proven successful. Long before the pandemic, there were successful companies — including Costco and QuikTrip — that knew their frontline workers were essential personnel and treated and paid them as such. Even in very competitive, low-cost retail sectors, these companies adopted a good jobs system and used it to win.

There’s a strong financial case for good jobs. Offering good jobs lowers costs by reducing employee turnover, operational mistakes, and wasted time. It improves service, which increases sales both in the short term and — through customer loyalty — in the long term.

The info is here.