In Japan, more people died from suicide last month than from Covid in all of 2020

S. Wang, R. Wright, & Y. Wakatsuki

CNN.com

Originally posted 29 Nov 20

Here is an excerpt:

In Japan, government statistics show suicide claimed more lives in October than Covid-19 has over the entire year to date. The monthly number of Japanese suicides rose to 2,153 in October, according to Japan's National Police Agency. As of Friday, Japan's total Covid-19 toll was 2,087, the health ministry said.

Japan is one of the few major economies to disclose timely suicide data -- the most recent national data for the US, for example, is from 2018. The Japanese data could give other countries insights into the impact of pandemic measures on mental health, and which groups are the most vulnerable.

"We didn't even have a lockdown, and the impact of Covid is very minimal compared to other countries ... but still we see this big increase in the number of suicides," said Michiko Ueda, an associate professor at Waseda University in Tokyo, and an expert on suicides.

"That suggests other countries might see a similar or even bigger increase in the number of suicides in the future."

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Compounding those worries about income, women have been dealing with skyrocketing unpaid care burdens, according to the study. For those who keep their jobs, when children are sent home from school or childcare centers, it often falls to mothers to take on those responsibilities, as well as their normal work duties.

Increased anxiety about the health and well-being of children has also put an extra burden on mothers during the pandemic.

The info is here.

Freerolls and binds: making policy when information is missing

Duke, A. & Sunstein, C.

(2020). Behavioural Public Policy, 1-22. 

doi:10.1017/bpp.2020.51

Abstract

When policymakers focus on costs and benefits, they often find that hard questions become easy – as, for example, when the benefits clearly exceed the costs, or when the costs clearly exceed the benefits. In some cases, however, benefits or costs are difficult to quantify, perhaps because of limitations in scientific knowledge. In extreme cases, policymakers are proceeding in circumstances of uncertainty rather than risk, in the sense that they cannot assign probabilities to various outcomes. We suggest that in difficult cases in which important information is absent, it is useful for policymakers to consider a concept from poker: ‘freerolls.’ A freeroll exists when choosers can lose nothing from selecting an option but stand to gain something (whose magnitude may itself be unknown). In some cases, people display ‘freeroll neglect.’ In terms of social justice, John Rawls’ defense of the difference principle is grounded in the idea that, behind the veil of ignorance, choosers have a freeroll. In terms of regulatory policy, one of the most promising defenses of the Precautionary Principle sees it as a kind of freeroll. Some responses to climate change, pandemics and financial crises can be seen as near-freerolls. Freerolls and near-freerolls must be distinguished from cases involving cumulatively high costs and also from faux freerolls, which can be found when the costs of an option are real and significant, but not visible. ‘Binds’ are the mirror-image of freerolls; they involve options from which people are guaranteed to lose something (of uncertain magnitude). Some regulatory options are binds, and there are faux binds as well.

From the Conclusion

In ordinary life, people may be asked whether they want a freeroll, in the form of a good or opportunity from which they will lose nothing, but from which they gain something of value, when the magnitude of the gain cannot be specified. The gain might take the form of the elimination of a risk. More commonly, people are given near-freerolls, because they have to pay something for the option. Often what they have to pay is very low, which makes the deal a good one. The central point here is an asymmetry in what people know. They know the costs, while they have large epistemic gaps with respect to the potential gains. People often fall prey to ‘freeroll neglect.’ When this is so, they do not see pure or near-freerolls; they seek missing information before choosing among options, even though they have no need to do so.

Freerolls are mirrored by binds, in which people are given an option from which they can only lose, even though they do not know how much they might lose. To know that binds are undesirable, the chooser need not have full knowledge about the range of possible downside outcomes. Nor need the chooser know anything about the shape of the distribution of those outcomes.

Toward a Hierarchical Model of Social Cognition: A Neuroimaging Meta-Analysis and Integrative Review of Empathy and Theory of Mind

Schurz, M. et al.

Psychological Bulletin. 

Advance online publication. 

http://dx.doi.org/10.1037/bul0000303

Abstract

Along with the increased interest in and volume of social cognition research, there has been higher awareness of a lack of agreement on the concepts and taxonomy used to study social processes. Two central concepts in the field, empathy and Theory of Mind (ToM), have been identified as overlapping umbrella terms for different processes of limited convergence. Here, we review and integrate evidence of brain activation, brain organization, and behavior into a coherent model of social-cognitive processes. We start with a meta-analytic clustering of neuroimaging data across different social-cognitive tasks. Results show that understanding others’ mental states can be described by a multilevel model of hierarchical structure, similar to models in intelligence and personality research. A higher level describes more broad and abstract classes of functioning, whereas a lower one explains how functions are applied to concrete contexts given by particular stimulus and task formats. Specifically, the higher level of our model suggests 3 groups of neurocognitive processes: (a) predominantly cognitive processes, which are engaged when mentalizing requires self-generated cognition decoupled from the physical world; (b) more affective processes, which are engaged when we witness emotions in others based on shared emotional, motor, and somatosensory representations; (c) combined processes, which engage cognitive and affective functions in parallel. We discuss how these processes are explained by an underlying principal gradient of structural brain organization. Finally, we validate the model by a review of empathy and ToM task interrelations found in behavioral studies.

Public Significance Statement

Empathy and Theory of Mind are important human capacities for understanding others. Here, we present a meta-analysis of neuroimaging data from 4,207 participants, which shows that these abilities can be deconstructed into specific and partially shared neurocognitive subprocesses. Our findings provide systematic, large-scale support for the hypothesis that understanding others’ mental states can be described by a multilevel model of hierarchical structure, similar to models in intelligence and personality research.

Where Are The Self-Correcting Mechanisms In Science?

Vazire, S., & Holcombe, A. O. 

(2020, August 13).

https://doi.org/10.31234/osf.io/kgqzt

Abstract

It is often said that science is self-correcting, but the replication crisis suggests that, at least in some fields, self-correction mechanisms have fallen short of what we might hope for. How can we know whether a particular scientific field has effective self-correction mechanisms, that is, whether its findings are credible? The usual processes that supposedly provide mechanisms for scientific self-correction – mainly peer review and disciplinary committees – have been inadequate. We argue for more verifiable indicators of a field’s commitment to self-correction. These include transparency, which is already a target of many reform efforts, and critical appraisal, which has received less attention. Only by obtaining Measurements of Observable Self-Correction (MOSCs) can we begin to evaluate the claim that “science is self-correcting.” We expect the validity of this claim to vary across fields and subfields, and suggest that some fields, such as psychology and biomedicine, fall far short of an appropriate level of transparency and, especially, critical appraisal. Fields without robust, verifiable mechanisms for transparency and critical appraisal cannot reasonably be said to be self-correcting, and thus do not warrant the credibility often imputed to science as a whole.

Oncologist Pays for Patient's Meds: A 'Boundary' Crossed?

Nic Mulcahy

medscape.com

Originally posted 4 Nov 20

It was an act of kindness: while overseeing a patient through a round of chemotherapy, an oncology fellow at Johns Hopkins University's Kimmel Comprehensive Cancer Center in Baltimore, Maryland, paid a modest amount of money (about $10) for that patient's antiemetic medication and retrieved it from the center's pharmacy.

Co-fellow Arjun Gupta, MD, witnessed the act and shared it with the world September 23 on Twitter.

"Just observed a co-fellow pay the co-pay for a patient's post-chemo nausea meds at the pharmacy, arrange them in a pill box, and deliver them to the patient in the infusion center. So that the patient could just leave after chemo."

Healthcare professionals applauded the generosity. "Phenomenal care," tweeted Carolyn Alexander, MD, a fertility physician in Los Angeles.

It's a common occurrence, said others. "Go ask a nurse how many times they've done it. I see it happen weekly," tweeted Chelsea Mitchell, PharmD, an intensive care unit pharmacist in Memphis, Tennessee.

Lack of universal healthcare brings about these moments, claimed multiple professionals who read Gupta's anecdote. "#ThisIsDoctoring. This is also a shameful indictment of our medical system," said Mary Landrigan-Ossar, MD, an anesthesiologist at Children's Hospital, Boston, Massachusetts.

However, one observer called out something no one else had ― that paying for a patient's medication is not allowed in some facilities.

The info is here.

The subjective turn

Jon Stewart

aeon.co

Originally posted 2 Nov 20

What is the human being? Traditionally, it was thought that human nature was something fixed, given either by nature or by God, once and for all. Humans occupy a unique place in creation by virtue of a specific combination of faculties that they alone possess, and this is what makes us who we are. This view comes from the schools of ancient philosophy such as Platonism, Aristotelianism and Stoicism, as well as the Christian tradition. More recently, it has been argued that there is actually no such thing as human nature but merely a complex set of behaviours and attitudes that can be interpreted in different ways. For this view, all talk of a fixed human nature is merely a naive and convenient way of discussing the human experience, but doesn’t ultimately correspond to any external reality. This view can be found in the traditions of existentialism, deconstruction and different schools of modern philosophy of mind.

There is, however, a third approach that occupies a place between these two. This view, which might be called historicism, claims that there is a meaningful conception of human nature, but that it changes over time as human society develops. This approach is most commonly associated with the German philosopher G W F Hegel (1770-1831). He rejects the claim of the first view, that of the essentialists, since he doesn’t think that human nature is something given or created once and for all. But he also rejects the second view since he doesn’t believe that the notion of human nature is just an outdated fiction we’ve inherited from the tradition. Instead, Hegel claims that it’s meaningful and useful to talk about the reality of some kind of human nature, and that this can be understood by an analysis of human development in history. Unfortunately, Hegel wrote in a rather inaccessible fashion, which has led many people to dismiss his views as incomprehensible or confused. His theory of philosophical anthropology, which is closely connected to his theory of historical development, has thus remained the domain of specialists. It shouldn’t.

With his astonishing wealth of knowledge about history and culture, Hegel analyses the ways in which what we today call subjectivity and individuality first arose and developed through time. He holds that, at the beginning of human history, people didn’t conceive of themselves as individuals in the same way that we do today. There was no conception of a unique and special inward sphere that we value so much in our modern self-image. Instead, the ancients conceived of themselves primarily as belonging to a larger group: the family, the tribe, the state, etc. This meant that questions of individual freedom or self-determination didn’t arise in the way that we’re used to understanding them.

The information is here.

How to know who’s trustworthy

T. Ryan Byerly

psyche.co

Originally posted 4 Nov 2020

Here is an excerpt:

An interesting fact about the virtues of intellectual dependability is that they are both intellectual and moral virtues. They’re ‘intellectual’ in the sense that they’re concerned with intellectual goods such as knowledge and understanding; but they’re moral virtues too, because they’re concerned with the intellectual goods of others. Indeed, the moral, other-regarding features of these virtues are especially central in a way that’s different to other intellectual virtues, such as inquisitiveness or intellectual perseverance.

It is in part because of the centrality of their other-regarding dimensions that the virtues of intellectual dependability haven’t taken on a larger role in education. The reigning paradigm of what we should aim for in education is that of the critical thinker. But being a critical thinker doesn’t necessarily mean that you possess other-regarding qualities, such as the virtues of intellectual dependability.

While we might lament this fact when it comes to formal education, we can still make efforts to become more intellectually dependable on our own. And we arguably should try to do so. After all, it’s not just us who are in need of dependable guides in our networks – we need to be intellectually dependable for the sake others, too.

If we want to grow in these virtues of intellectual dependability – to become more benevolent, transparent and so on – what can we do? The following are four strategies that researchers tend to agree can help us grow in intellectual virtue.

A first strategy is direct instruction – learning about the nature of particular intellectual virtues that we hope to cultivate. Ideally, we’ll gain an account of what the virtue involves, and we might learn about the vices that oppose it. Part of the reason why direct instruction is important is that it helps to reduce our cognitive load. It gives us a framework to think through our intellectual life. It also helps us set a target to aim for.

A second strategy is to think how intellectual virtues apply in particular situations, considering what the intellectual virtue – and perhaps also its opposing vices – looks like in action. You might select some historical, contemporary or even fictional examples of people who appear to act in accordance with the virtue or its opposing vice. By encountering exemplars, you might gain a taste or sensibility for the virtue, and a person to emulate. More generally, this exercise can help you to practise evaluating scenarios in which intellectual virtues can influence behaviour. When done well, this can help you appreciate the variety of contexts in which intellectual virtues make a difference, and the different kinds of behaviour they lead to.

The info is here.

Ethical & Legal Considerations of Patients Audio Recording, Videotaping, & Broadcasting Clinical Encounters

Ferguson BD, Angelos P. 

JAMA Surg. 

Published online October 21, 2020. 

doi:10.1001/jamasurg.2020.2968

Given the increased availability of smartphones and other devices capable of capturing audio and video, it has become increasingly easy for patients to record medical encounters. This behavior can occur overtly, with or without the physician’s express consent, or covertly, without the physician’s knowledge or consent. The following hypothetical cases demonstrate specific scenarios in which physicians have been recorded during patient care.

A patient has come to your clinic seeking a second opinion. She was recently treated for cholangiocarcinoma at another hospital. During her postoperative course, major complications occurred that required a prolonged index admission and several interventional procedures. She is frustrated with the protracted management of her complications. In your review of her records, it becomes evident that her operation may not have been indicated; moreover, it appears that gross disease was left in situ owing to the difficulty of the operation. You eventually recognize that she was never informed of the intraoperative findings and final pathology report. During your conversation, you notice that her husband opens an audio recording app on his phone and places it face up on the desk to document your conversation.

(cut) 

From the Discussion

Each of these cases differs, yet each reflects the general issue of patients recording interactions with their physicians. In the following discussion, we explore a number of ethical and legal considerations raised by such cases and offer suggestions for ways physicians might best navigate these complex situations.

These cases illustrate potentially difficult patient interactions—the first, a delicate conversation involving surgical error; the second, ongoing management of a life-threatening postoperative complication; and the third, a straightforward bedside procedure involving unintended bystanders. When audio or video recording is introduced in clinical encounters, the complexity of these situations can be magnified. It is sometimes challenging to balance a patient’s need to document a physician encounter with the desire for the physician to maintain the patient-physician relationship. Patient autonomy depends on the fidelity with which information is transferred from physician to patient. 

In many cases, patients record encounters to ensure well-informed decision making and therefore to preserve autonomy. In others, patients may have ulterior motives for recording an encounter.

The logic of universalization guides moral judgment

Levine, S., et al.

PNAS October 20, 2020 

117 (42) 26158-26169; 

first published October 2, 2020; 

https://doi.org/10.1073/pnas.2014505117

Abstract

To explain why an action is wrong, we sometimes say, “What if everybody did that?” In other words, even if a single person’s behavior is harmless, that behavior may be wrong if it would be harmful once universalized. We formalize the process of universalization in a computational model, test its quantitative predictions in studies of human moral judgment, and distinguish it from alternative models. We show that adults spontaneously make moral judgments consistent with the logic of universalization, and report comparable patterns of judgment in children. We conclude that, alongside other well-characterized mechanisms of moral judgment, such as outcome-based and rule-based thinking, the logic of universalizing holds an important place in our moral minds.

Significance

Humans have several different ways to decide whether an action is wrong: We might ask whether it causes harm or whether it breaks a rule. Moral psychology attempts to understand the mechanisms that underlie moral judgments. Inspired by theories of “universalization” in moral philosophy, we describe a mechanism that is complementary to existing approaches, demonstrate it in both adults and children, and formalize a precise account of its cognitive mechanisms. Specifically, we show that, when making judgments in novel circumstances, people adopt moral rules that would lead to better consequences if (hypothetically) universalized. Universalization may play a key role in allowing people to construct new moral rules when confronting social dilemmas such as voting and environmental stewardship.