Association of Physician Burnout With Suicidal Ideation and Medical Errors

Menon NK, Shanafelt TD, Sinsky CA, et al. 

JAMA Netw Open. 2020;3(12):e2028780. 

doi:10.1001/jamanetworkopen.2020.28780

Key Points

Question  Is burnout associated with increased suicidal ideation and self-reported medical errors among physicians after accounting for depression?

Findings  In this cross-sectional study of 1354 US physicians, burnout was significantly associated with increased odds of suicidal ideation before but not after adjusting for depression and with increased odds of self-reported medical errors before and after adjusting for depression. In adjusted models, depression was significantly associated with increased odds of suicidal ideation but not self-reported medical errors.

Meaning  The findings suggest that depression but not burnout is directly associated with suicidal ideation among physicians.

Conclusions and Relevance  The results of this cross-sectional study suggest that depression but not physician burnout is directly associated with suicidal ideation. Burnout was associated with self-reported medical errors. Future investigation might examine whether burnout represents an upstream intervention target to prevent suicidal ideation by preventing depression.

The research is here.

'How Did We Get Here?' A Call For An Evangelical Reckoning On Trump

Rachel Martin

NPR.org

Originally poste 13 Jan 202

Here is an excerpt:

You write that Trump has burned down the Republican Party. What has he done to the evangelical Christian movement?

If you asked today, "What's an evangelical?" to most people, I would want them to say: someone who believes Jesus died on the cross for our sin and in our place and we're supposed to tell everyone about it. But for most people they'd say, "Oh, those are those people who are really super supportive of the president no matter what he does." And I don't think that's what we want to be known for. That's certainly not what I want to be known for. And I think as this presidency is ending in tatters as it is, hopefully more and more evangelicals will say, "You know, we should have seen earlier, we should have known better, we should have honored the Lord more in our actions these last four years."

Should ministers on Sunday mornings be delivering messages about how to sort fact from fiction and discouraging their parishioners from seeking truth in these darkest corners of the Internet peddling lies?

Absolutely, absolutely. Mark Noll wrote years ago a book called The Scandal of the Evangelical Mind, and he was talking about the lack of intellectual engagement in some corners of evangelicalism.

I think the scandal of the evangelical mind today is the gullibility that so many have been brought into — conspiracy theories, false reports and more — and so I think the Christian responsibility is we need to engage in what we call in the Christian tradition, discipleship. Jesus says, "I am the way, the truth and the life." So Jesus literally identifies himself as the truth; therefore, if there ever should be a people who care about the truth, it should be people who call themselves followers of Jesus.

The info is here.

Memorial Sloan Kettering Gave Top Doctor $1.5 Million After He Was Forced to Resign Over Conflicts of Interest

Katie Thomas & Charles Ornstein

ProPublica

Originally published 22 Dec 20

Here is an excerpt:

After months of review, Memorial Sloan Kettering overhauled its conflict-of-interest policy, barring its top executives from serving on corporate boards of drug and health care companies and placing limits on how executives and top researchers could profit from work developed at the institution.

Like other major hospitals, Memorial Sloan Kettering’s finances have taken a hit during the coronavirus pandemic. For the first three quarters of 2020, the hospital reported an operating loss of $453 million compared with an operating profit of nearly $77 million in the first nine months of 2019. The hospital saw a decline in surgical procedures and clinic visits, as well as clinical trials and other research. The hospital did receive $100 million in relief funds as part of the Coronavirus Aid, Relief and Economic Security (CARES) Act.

Baselga wasn’t the only former official to receive severance from Memorial Sloan Kettering in 2019. It also paid more than $250,000 in severance to Avice Meehan, the hospital’s former chief communications officer, according to its IRS filing. Meehan declined to comment.

Laurie Styron, the executive director of CharityWatch, an independent watchdog group, said that hospitals often compensate their staff generously because they must attract highly trained and educated doctors who would be well-paid elsewhere. Still, she said, the multimillion-dollar sums can surprise donors, who typically give money to support research or patient care.

The info is here.

Physical Attractiveness in the Legal System

Rod Hollier

The Law Project

When I started looking into this subject, I predicted a person’s physical attractiveness would only have minor advantages. I was wrong.

In fact, I was so wrong, that in one study, the effects of physical attractiveness on judges were so influential, they fined unattractive criminals 304.88% higher than attractive criminals.

Surprising, I know.

Before we proceed, I want to address a few concerns of mine. Firstly, the information that you will read may cause some readers to feel unsettled. This is not my intention. Yes, it is disheartening. But the purpose of this article is to inform lawyers and other decision makers so that they can use the attractiveness bias to their advantage or to counter it.

A second concern of mine is that I don’t want to over-emphasise the attractiveness bias. Judges and jurors are affected by all kinds of cognitive distortions, such as emotive evidence, time of day, remorse of the defendant, socioeconomic status, race, gender, anchoring effect, and the contrast bias.

In the first section of this article, I give a ‘straight-to-the-point’ summary of the research conducted by 27 studies. Next, I enter into greater depth on the attractiveness bias and its effects on judges, jurors, and lawyers. Lastly, I provide research on the attractiveness bias in everyday life. Arguably, the last section is the most interesting.

The studies and further information is here.

APA President and CEO condemn violence at Capitol

Jennifer Kelly, PhD & Arthur Evans, PhD

American Psychological Association

January 8, 2021

Dear APA Members,

The recent storming of the U.S. Capitol has shocked our nation and the world. After 200 years of peaceful transfers of power between political parties, we were assaulted with images of rioters desecrating one of our greatest symbols of democracy. Regardless of our political views, we can agree that hate and violence toward each other are never acceptable. 

All of this took place as our nation has been emerging from a year dominated by trauma—a rapidly spreading virus, widespread divisiveness, and economic uncertainty. These layers of trauma are cumulative, and make it  difficult to function.

Psychology is of immense value in a time of such complex tragedy and trauma. It is vital that our science and professional expertise are utilized to help heal the political, economic, and ideological divides in our country.

Misinformation and conspiracy theories are at the root of this week’s tragedies. Despite every state certifying the results, and those results being validated by dozens of courts across the nation, repeated claims from the President that the presidential election was “rigged” or “stolen” drove Wednesday’s demonstrators to engage in the mayhem we witnessed. As psychologists, we understand the human propensity toward confirmation bias. We must continue to educate people on how to resist seeking out information that supports their own viewpoint and promote the use of techniques that encourage more objective consideration. The continued propagation of mistruths fosters tribalism, outrage, and rancor, which prevents us as individuals from seeing our shared humanity and interests.

There is much to do, and APA is taking action. We have been educating reporters and the public on the science underlying trauma and resilience, political psychology and polarization, misinformation and conspiracy theories, and how to talk to children about traumatic events. We have been working with members of Congress and both the outgoing and the incoming administrations to ensure that psychology and our science is not just at the table, but informing vital decisions. Our APA task force on police use of force is underway and releasing recommendations early this year. And our members—all of you—are using your expertise to help individuals, communities, and policymakers.

The work that we do as a field is critical. It is understandable if you are feeling shaken, angry, or emotionally exhausted. But recognize that—as a part of the APA community—you are not alone. We are all in this together and we must be intentional in taking care of ourselves and supporting each other as we work through this national trauma in all its forms. 

Our nation faces immense challenges that will not end on Inauguration Day. Psychology and our association must play a critical role in addressing those challenges. Most people—across the political spectrum—want the best for our country. Together, we must look toward the future. Psychologists offer science and expertise that can promote hope, resilience, and a path forward for a nation that is in trauma and in need of healing. APA is committed to doing that work with all of you.

Is that artificial intelligence ethical? Sony to review all products

NikkeiAsia

Nikkei staff writers

Originally posted 22 Dec 2020

Here is an excerpt:

Sony will start screening all of its AI-infused products for ethical risks as early as spring, Nikkei has learned. If a product is deemed ethically deficient, the company will improve it or halt development.

Sony uses AI in its latest generation of the Aibo robotic dog, for instance, which can recognize up to 100 faces and continues to learn through the cloud.

Sony will incorporate AI ethics into its quality control, using internal guidelines.

The company will review artificially intelligent products from development to post-launch on such criteria as privacy protection. Ethically deficient offerings will be modified or dropped.

An AI Ethics Committee, with its head appointed by the CEO, will have the power to halt development on products with issues.

Even products well into development could still be dropped. Ones already sold could be recalled if problems are found. The company plans to gradually broaden the AI ethics rules to offerings in finance and entertainment as well.

As AI finds its way into more devices, the responsibilities of developers are increasing, and companies are strengthening ethical guidelines.

The info is here.

'The robot made me do it': Robots encourage risk-taking behaviour in people

Press Release

University of Southampton

Originally released 11 Dec 20

New research has shown robots can encourage people to take greater risks in a simulated gambling scenario than they would if there was nothing to influence their behaviours. Increasing our understanding of whether robots can affect risk-taking could have clear ethical, practiCal and policy implications, which this study set out to explore.

Dr Yaniv Hanoch, Associate Professor in Risk Management at the University of Southampton who led the study explained, "We know that peer pressure can lead to higher risk-taking behaviour. With the ever-increasing scale of interaction between humans and technology, both online and physically, it is crucial that we understand more about whether machines can have a similar impact."

This new research, published in the journal Cyberpsychology, Behavior, and Social Networking, involved 180 undergraduate students taking the Balloon Analogue Risk Task (BART), a computer assessment that asks participants to press the spacebar on a keyboard to inflate a balloon displayed on the screen. With each press of the spacebar, the balloon inflates slightly, and 1 penny is added to the player's "temporary money bank". The balloons can explode randomly, meaning the player loses any money they have won for that balloon and they have the option to "cash-in" before this happens and move on to the next balloon.

One-third of the participants took the test in a room on their own (the control group), one third took the test alongside a robot that only provided them with the instructions but was silent the rest of the time and the final, the experimental group, took the test with the robot providing instruction as well as speaking encouraging statements such as "why did you stop pumping?"

The results showed that the group who were encouraged by the robot took more risks, blowing up their balloons significantly more frequently than those in the other groups did. They also earned more money overall. There was no significant difference in the behaviours of the students accompanied by the silent robot and those with no robot.

The pressor is here.

Doctors Dating Patients: Love, Actually?

Shelly Reese

medscape.com

Originally posted 10 Dec 20

Here is an excerpt:

Not surprisingly, those who have seen such relationships end in messy, contentious divorces or who know stories of punitive actions are stridently opposed to the idea. "Never! Grounds for losing your license"; "it could only result in trouble"; "better to keep this absolute"; "you're asking for a horror story," wrote four male physicians.

Although doctor-patient romances don't frequently come to the attention of medical boards or courts until they have soured, even "happy ending" relationships may come at a cost. For example, in 2017, the Iowa Board of Medicine fined an orthopedic surgeon $5000 and ordered him to complete a professional boundaries program because he became involved with a patient while or soon after providing care, despite the fact that the couple had subsequently married.

Ethics aside, "this is a very dangerous situation, socially and professionally," writes a male physician in Pennsylvania. A New York physician agreed: "Many of my colleagues marry their patients, even after they do surgery on them. It's a sticky situation."

Doctors' Attitudes Are Shifting

The American Medical Association clearly states that sexual contact that is concurrent with the doctor/patient relationship constitutes sexual misconduct and that even a romance with a former patient "may be unduly influenced by the previous physician-patient relationship."

Although doctors' attitudes on the subject are evolving, that's not to say they suddenly believe they can start asking their patients out to dinner. Very few doctors (2%) condone romantic relationships with existing patients — a percentage that has remained largely unchanged over the past 10 years. Instead, physicians are taking a more nuanced approach to the issue.

The info is here.

The Last Children of Down Syndrome

Sarah Zhang

The Atlantic

Originally posted December 2020

Here is an excerpt:

Eugenics in Denmark never became as systematic and violent as it did in Germany, but the policies came out of similar underlying goals: improving the health of a nation by preventing the birth of those deemed to be burdens on society. The term eugenics eventually fell out of favor, but in the 1970s, when Denmark began offering prenatal testing for Down syndrome to mothers over the age of 35, it was discussed in the context of saving money—as in, the testing cost was less than that of institutionalizing a child with a disability for life. The stated purpose was “to prevent birth of children with severe, lifelong disability.”

That language too has long since changed; in 1994, the stated purpose of the testing became “to offer women a choice.” Activists like Fält-Hansen have also pushed back against the subtle and not-so-subtle ways that the medical system encourages women to choose abortion. Some Danish parents told me that doctors automatically assumed they would want to schedule an abortion, as if there was really no other option. This is no longer the case, says Puk Sandager, a fetal-medicine specialist at Aarhus University Hospital. Ten years ago, doctors—especially older doctors—were more likely to expect parents to terminate, she told me. “And now we do not expect anything.” The National Down Syndrome Association has also worked with doctors to alter the language they use with patients—“probability” instead of “risk,” “chromosome aberration” instead of “chromosome error.” And, of course, hospitals now connect expecting parents with people like Fält-Hansen to have those conversations about what it’s like to raise a child with Down syndrome.

The info is here.