My Bedside Manner Got Worse During The Pandemic. Here's How I Improved

Shahdabul Faraz
npr.org
Health Shots
Originally published 16 May 20

Here is an excerpt:

These gestures can be as simple as sitting in a veteran's room for an extra five minutes to listen to World War II stories. Or listening with a young cancer patient to a song by our shared favorite band. Or clutching a sick patient's shoulder and reassuring him that he will see his three daughters again.

These gestures acknowledge a patient's humanity. It gives them some semblance of normalcy in an otherwise difficult period in their lives. Selfishly, that human connection also helps us — the doctors, nurses and other health care providers — deal with the often frustrating nature of our stressful jobs.

Since the start of the pandemic, our bedside interactions have had to be radically different. Against our instincts, and in order to protect our patients and colleagues, we tend to spend only the necessary amount of time in our patients' rooms. And once inside, we try to keep some distance. I have stopped holding my patients' hands. I now try to minimize small talk. No more whimsical conversational detours.

Our interactions now are more direct and short. I have, more than once, felt guilty for how quickly I've left a patient's room. This guilt is worsened, knowing that patients in hospitals don't have family and friends with them now either. Doctors are supposed to be there for our patients, but it's become harder than ever in recent months.

I understand why these changes are needed. As I move through several hospital floors, I could unwittingly transmit the virus if I'm infected and don't know it. I'm relatively young and healthy, so if I get the disease, I will likely recover. But what about my patients? Some have compromised immune systems. Most are elderly and have more than one high-risk medical condition. I could never forgive myself if I gave one of my patients COVID-19.

The info is here.

Better Minds, Better Morals A Procedural Guide to Better Judgment

Schaefer GO, Savulescu J.
J Posthum Stud. 2017;1(1):26‐43.
doi:10.5325/jpoststud.1.1.0026

Abstract

Making more moral decisions - an uncontroversial goal, if ever there was one. But how to go about it? In this article, we offer a practical guide on ways to promote good judgment in our personal and professional lives. We will do this not by outlining what the good life consists in or which values we should accept.Rather, we offer a theory of procedural reliability: a set of dimensions of thought that are generally conducive to good moral reasoning. At the end of the day, we all have to decide for ourselves what is good and bad, right and wrong. The best way to ensure we make the right choices is to ensure the procedures we're employing are sound and reliable. We identify four broad categories of judgment to be targeted - cognitive, self-management, motivational and interpersonal. Specific factors within each category are further delineated, with a total of 14 factors to be discussed. For each, we will go through the reasons it generally leads to more morally reliable decision-making, how various thinkers have historically addressed the topic, and the insights of recent research that can offer new ways to promote good reasoning. The result is a wide-ranging survey that contains practical advice on how to make better choices. Finally, we relate this to the project of transhumanism and prudential decision-making. We argue that transhumans will employ better moral procedures like these. We also argue that the same virtues will enable us to take better control of our own lives, enhancing our responsibility and enabling us to lead better lives from the prudential perspective.

A pdf is here.

Measuring Information Preferences

E. H. Ho, D. Hagmann, & G. Loewenstein
Management Science
Published Online:13 Mar 2020

Abstract

Advances in medical testing and widespread access to the internet have made it easier than ever to obtain information. Yet, when it comes to some of the most important decisions in life, people often choose to remain ignorant for a variety of psychological and economic reasons. We design and validate an information preferences scale to measure an individual’s desire to obtain or avoid information that may be unpleasant but could improve future decisions. The scale measures information preferences in three domains that are psychologically and materially consequential: consumer finance, personal characteristics, and health. In three studies incorporating responses from over 2,300 individuals, we present tests of the scale’s reliability and validity. We show that the scale predicts a real decision to obtain (or avoid) information in each of the domains as well as decisions from out-of-sample, unrelated domains. Across settings, many respondents prefer to remain in a state of active ignorance even when information is freely available. Moreover, we find that information preferences are a stable trait but that an individual’s preference for information can differ across domains.

General Discussion

Making good decisions is often contingent on obtaining information, even when that
information is uncertain and has the potential to produce unhappiness. Substantial empirical
evidence suggests that people are often ready to make worse decisions in the service of avoiding
potentially painful information. We propose that this tendency to avoid information is a trait that
is separate from those measured previously, and developed a scale to measure it. The scale asks
respondents to imagine how they would respond to a variety of hypothetical decisions involving
information acquisition/avoidance. The predictive validity of the IPS appears to be largely driven
by its domain items, and although it incorporates domain-specific subscales, it appears to be
sufficiently universal to capture preferences for information in a broad range of domains.

The research is here.

We already knew, to some extent, that there are cases where people avoid information.  This is important in psychotherapy in which avoidance promotes confirmatory hypothesis testing, which enhances overconfidence.  We need to help people embrace information that may be inconsistent or incongruent with their worldview.

13th is now free on YouTube

Combining archival footage with testimony from activists and scholars, director Ava DuVernay's examination of the U.S. prison system looks at how the country's history of racial inequality drives the high rate of incarceration in America.

This piercing, Oscar-nominated film won Best Documentary at the Emmys, the BAFTAs and the NAACP Image Awards.

 US Rating: TV-MA For mature audiences. May not be suitable for ages 17 and under.

Vice dressed as virtue

Paul Russell
aeon.com
Originally published 22 May 20

Here is an excerpt:

When I speak of moralism, in this context, what I am concerned with, in general terms, is the misuse of morality for ends and purposes that are themselves vicious or corrupt. Moralisers present the facade of genuine moral concern but their real motivations rest with interests and satisfactions of a very different character. When these motivations are unmasked, they are shown to be tainted and considerably less attractive than we suppose. Among these motivations are cruelty, malice and sadism. Not all forms of moralism, however, are motivated in this way. On the contrary, it could be argued that the most familiar and common form of moralism is rooted not in cruelty but in vanity.

The basic idea behind vain moralism is that the agents’ (moral) conduct and conversation is motivated with a view to inflating their social and moral standing in the eyes of others. This is achieved by way of flaunting their moral virtues for others to praise and admire. Any number of moralists through the ages – reaching back to the likes of François de La Rochefoucauld (1613-80) and Bernard Mandeville (1670-1733) – have attempted to show that it is vanity that lies behind most, if not all, of our moral conduct and activity. While theories of this kind no doubt exaggerate and distort the truth, they do make sense of much of what troubles us about moralism.

One feature of vain moralism that is especially troubling is that an excessive or misplaced concern with our moral reputation and standing suggests that moralisers of this kind lack any deep or sincere commitment to the values, principles and ideals that they want others to believe animates their conduct and character. Moralisers of this kind are essentially superficial and fraudulent. We have, of course, countless examples of this sort of moral personality, ranging from Evangelical preachers caught in airport motels taking drugs with male prostitutes, to any number of highly paid professors wining and dining on the lecture circuit while explaining the need for social justice and advocating extreme forms of egalitarianism. For the most part, these characters and their activities – whatever their doctrine – are a matter of ridicule rather than of grave moral concern. Over time, the motivations behind their ‘grandstanding’ and ‘virtue signalling’ will be exposed for what it is, and the moralisers’ shallow commitment to their professed ideals and values becomes apparent to all. While we shouldn’t dismiss the vain moraliser as simply innocuous, there is no essential connection between moralism of this kind and cruelty or sadism.

The info is here.

Prejudiced and unaware of it: Evidence for the Dunning-Kruger model in the domains of racism and sexism

K. West and A. A. Eaton
Personality and Individual Differences
Volume 146, 1 August 2019, Pages 111-119

Abstract

Prior research, and high-prolife contemporary examples, show that individuals tend to underestimate their own levels of bias. This underestimation is partially explained by motivational factors. However, (meta-) cognitive factors may also be involved. Conceptualising contemporary egalitarianism as type of skill or competence, this research proposed that egalitarianism should conform to the Dunning-Kruger model. That is, individuals should overestimate their own ability, and this overestimation should be strongest in the least competent individuals. Furthermore, training should improve metacognition and reduce this overestimation. Two studies on racism (N = 148), and sexism (N = 159) partially supported these hypotheses. In line with the Dunning-Kruger model, participants overestimated their levels of racial and gender-based egalitarianism, and this pattern was strongest among the most prejudiced participants. However, diversity training did not affect participants' overestimation of their egalitarianism. Implications for contemporary prejudice, and prejudice-reducing strategies are discussed.

(cut)

Conclusions

For many reasons, contemporary discussions of prejudice can be quite acrimonious. Members of socially advantaged groups may find such discussions difficult, unpleasant, or threatening Apfelbaum, Pauker, Ambady, Sommers, & Norton, 2008; Dover, Major, & Kaiser, 2016; Norton et al., 2006). Political divisions may lead members of both advantaged and disadvantaged groups to attribute overly negative motivations to the other group (Goff et al., 2014; Reeder, 2005; Taber, Brook, & Franklin, 2006). Motivation certainly forms an important part of the picture. However, this research suggests that, even if such motivational considerations were accounted for, there may be important cognitive hindrances to understanding and reducing prejudice that would have to be addressed. In line with the Dunning-Kruger model, this research found that very prejudiced individuals (i.e., those low in egalitarianism) may be genuinely unaware of their shortcomings because they lack the meta-cognition necessary to perceive them. It is thus possible that some solutions to contemporary prejudice may rely less on motivation and more on education.

The research is here.

Concealment of nonreligious identity: Exploring social identity threat among atheists and other nonreligious individuals

Mackey, C. D., Silver, and others
(2020). Group Processes & Intergroup Relations.
https://doi.org/10.1177/1368430220905661

Abstract

Negative attitudes toward the nonreligious persist in America. This may compel some nonreligious individuals to conceal their identity to manage feelings of social identity threat. In one correlational study and one experiment, we found evidence of social identity threat and concealment behavior among nonreligious Americans. Our first study showed that Southern nonreligious individuals reported higher levels of stigma consciousness and self-reported concealment of nonreligious identity, which in turn predicted lower likelihood of self-identifying as “atheist” in public settings than in private settings. Our second study successfully manipulated feelings of social identity threat by showing that atheists who read an article about negative stereotypes of their group subsequently exhibited higher concealment scores than did atheists who read one of two control articles. Implications for how nonreligious individuals negotiate social identity threat and future directions for nonreligion research are discussed.

Suicide Risk Increases Immediately After Gun Purchase

Psychiatric News Alert
Originally published 11 June 20

A study published in the New England Journal of Medicine expands on past research on the association between access to guns and suicide, finding that handgun ownership is associated with an elevated risk of suicide by firearm, particularly immediately after the gun is acquired.

Since the COVID-19 pandemic began, gun sales have sharply increased, an accompanying commentary pointed out. In March, Americans bought nearly two million guns, marking the second-highest monthly total since 1998, when the Federal Bureau of Investigation (FBI) began publishing such data.

“How will the current surge of gun purchases affect firearm-related violence?” wrote Chana A. Sacks, M.D., M.P.H., and Stephen J. Bartels, M.D., in their commentary. “With an additional 2 million guns now in households across the country at a time of widespread unemployment, social isolation, and acute national stress that is unprecedented in our lifetime, we urgently need to find out.”

Lead author David M. Studdert, LL.B., Sc.D., of the Stanford Law School and School of Medicine and colleagues tracked firearm ownership and mortality over 12 years (2004-2016) among 26.3 million adults in California. They used the California Statewide Voter Registration Database to form the cohort, as the database updates its information on registered voters in the state every year.

The researchers then used the California Department of Justice’s Dealer Record of Sale for details on which cohort members acquired handguns and when. Additionally, the California Death Statistical Master Files provided records of all deaths reported during the study period.

The alert is here.

The dual evolutionary foundations of political ideology

S. Claessens, K. Fischer, and others
PsyArXiv
Originally published 18 June 19

Abstract

What determines our views on taxation and crime, healthcare and religion, welfare and gender roles? And why do opinions about these seemingly disparate aspects of our social lives coalesce the way they do? Research over the last 50 years has suggested that political attitudes and values around the globe are shaped by two ideological dimensions, often referred to as economic and social conservatism. However, it remains unclear why this ideological structure exists. Here, we highlight the striking concordance between these two dimensions of ideology and two key aspects of human sociality: cooperation and group conformity. Humans cooperate to a greater degree than our great ape relatives, paying personal costs to benefit others. Humans also conform to group-wide social norms and punish norm violators in interdependent, culturally marked groups. Together, these two shifts in sociality are posited to have driven the emergence of large-scale complex human societies. We argue that fitness trade-offs and behavioural plasticity have maintained strategic individual differences in both cooperation and group conformity, naturally giving rise to the two dimensions of political ideology. Supported by evidence from psychology, behavioural genetics, behavioural economics, and primatology, this evolutionary framework promises novel insight into the biological and cultural basis of political ideology.

The research is here.