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

Monday, June 28, 2021

You are a network

Kathleen Wallace
aeon.com
Originally published

Here is an excerpt:

Social identities are traits of selves in virtue of membership in communities (local, professional, ethnic, religious, political), or in virtue of social categories (such as race, gender, class, political affiliation) or interpersonal relations (such as being a spouse, sibling, parent, friend, neighbour). These views imply that it’s not only embodiment and not only memory or consciousness of social relations but the relations themselves that also matter to who the self is. What philosophers call ‘4E views’ of cognition – for embodied, embedded, enactive and extended cognition – are also a move in the direction of a more relational, less ‘container’, view of the self. Relational views signal a paradigm shift from a reductive approach to one that seeks to recognise the complexity of the self. The network self view further develops this line of thought and says that the self is relational through and through, consisting not only of social but also physical, genetic, psychological, emotional and biological relations that together form a network self. The self also changes over time, acquiring and losing traits in virtue of new social locations and relations, even as it continues as that one self.

How do you self-identify? You probably have many aspects to yourself and would resist being reduced to or stereotyped as any one of them. But you might still identify yourself in terms of your heritage, ethnicity, race, religion: identities that are often prominent in identity politics. You might identify yourself in terms of other social and personal relationships and characteristics – ‘I’m Mary’s sister.’ ‘I’m a music-lover.’ ‘I’m Emily’s thesis advisor.’ ‘I’m a Chicagoan.’ Or you might identify personality characteristics: ‘I’m an extrovert’; or commitments: ‘I care about the environment.’ ‘I’m honest.’ You might identify yourself comparatively: ‘I’m the tallest person in my family’; or in terms of one’s political beliefs or affiliations: ‘I’m an independent’; or temporally: ‘I’m the person who lived down the hall from you in college,’ or ‘I’m getting married next year.’ Some of these are more important than others, some are fleeting. The point is that who you are is more complex than any one of your identities. Thinking of the self as a network is a way to conceptualise this complexity and fluidity.

Let’s take a concrete example. Consider Lindsey: she is spouse, mother, novelist, English speaker, Irish Catholic, feminist, professor of philosophy, automobile driver, psychobiological organism, introverted, fearful of heights, left-handed, carrier of Huntington’s disease (HD), resident of New York City. This is not an exhaustive set, just a selection of traits or identities. Traits are related to one another to form a network of traits. Lindsey is an inclusive network, a plurality of traits related to one another. The overall character – the integrity – of a self is constituted by the unique interrelatedness of its particular relational traits, psychobiological, social, political, cultural, linguistic and physical.

Sunday, June 27, 2021

On Top of Everything Else, the Pandemic Messed With Our Morals

Jonathan Moens
The Atlantic
Originally posted 8 June 21

Here is an excerpt:

The core features of moral injury are feelings of betrayal by colleagues, leaders, and institutions who forced people into moral quandaries, says Suzanne Shale, a medical ethicist. As a way to minimize exposure for the entire team, Kathleen Turner and other ICU nurses have had to take on multiple roles: cleaning rooms, conducting blood tests, running neurological exams, and standing in for families who can’t keep patients company. Juggling all those tasks has left Turner feeling abandoned and expendable. “It definitely exposes and highlights the power dynamics within health care of who gets to say ‘No, I'm too high risk; I can't go in that patient's room,’” she said. Kate Dupuis, a clinical neuropsychiatrist and researcher at Canada’s Sheridan College, also felt her moral foundations shaken after Ontario’s decision to shut down schools for in-person learning at the start of the pandemic. The closures have left her worrying about the potential mental-health consequences this will have on her children.

For some people dealing with moral injury right now, the future might hold what is known as “post-traumatic growth,” whereby people’s sense of purpose is reinforced during adverse events, says Victoria Williamson, a researcher who studies moral injury at Oxford University and King’s College London. Last spring, Ahmed Ali, an imam in Brooklyn, New York, felt his moral code violated when dead bodies that were sent to him to perform religious rituals were improperly handled and had blood spilling from detached IV tubes. The experience has invigorated his dedication to helping others in the name of God. “That was a spiritual feeling,” he said.

But moral injury may leave other people feeling befuddled and searching for some way to make sense of a very bad year. If moral injury is left unaddressed, Greenberg said, there’s a real risk that people will develop depression, alcohol misuse, and suicidality. People suffering from moral injury risk retreating into isolation, engaging in self-destructive behaviors, and disconnecting from their friends and family. In the U.K., moral injury among military veterans has been linked to a loss of faith in organized religion. The psychological cost of a traumatic event is largely determined by what happens afterward, meaning that a lack of support from family, friends, and experts who can help people process these events—now that some of us are clawing our way out of the pandemic—could have serious mental-health repercussions. “This phase that we’re in now is actually the phase that’s the most important,” Greenberg said.

Saturday, June 26, 2021

Making moral principles suit yourself


Stanley, M.L., Henne, P., Niemi, L. et al. 
Psychon Bull Rev (2021). 
https://doi.org/10.3758/s13423-021-01935-8

Abstract

Normative ethical theories and religious traditions offer general moral principles for people to follow. These moral principles are typically meant to be fixed and rigid, offering reliable guides for moral judgment and decision-making. In two preregistered studies, we found consistent evidence that agreement with general moral principles shifted depending upon events recently accessed in memory. After recalling their own personal violations of moral principles, participants agreed less strongly with those very principles—relative to participants who recalled events in which other people violated the principles. This shift in agreement was explained, in part, by people’s willingness to excuse their own moral transgressions, but not the transgressions of others. These results have important implications for understanding the roles memory and personal identity in moral judgment. People’s commitment to moral principles may be maintained when they recall others’ past violations, but their commitment may wane when they recall their own violations.

From the General Discussion

 Moral disengagement mechanisms (e.g., distorting the consequences of actions, dehumanizing victims)
help people to convince themselves that their actions are permissible and that their ethical standards need not apply in certain contexts (Bandura, 1999; Bandura et al., 1996; Detert et al., 2008). These disengagement mechanisms are thought to help people to protect their favorable views of themselves.
Note that convincing oneself that a particular action is morally acceptable in a particular context via moral disengagement entails maintaining the same level of agreement with the overarching moral principles; the principle just does not apply in some particular context. In contrast, our findings suggest that by reflecting on their own morally objectionable actions, people’s agreement with the overarching, guiding principles
changes. It is not that the principle does not apply; it is that the principle is held with less conviction.

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Normative ethical theories and religious traditions that offer general moral principles are meant to help us to understand aspects of ourselves and our world in ways that offer insights and guidance for living a moral life (Albertzart, 2013; Väyrynen, 2008). Our findings introduce some cause for doubt about the stability of moral principles over time, and therefore, their reliability as accurate indicators of moral judgments and actions in the real world.

Friday, June 25, 2021

Rugged American Individualism is a Myth, and It’s Killing Us

Katherine Wasson
Hastings Center
Originally published 4 June 21

The starkest picture of rugged American individualism is one we learned in school. A family moves West to settle the land and struggles with the elements.  Yet, even in these depictions, settlers needed help to raise a barn or harvest crops. They drew on the help of others and reciprocated in return. In the 21st century few Americans live in any way close to this largely self-sustaining lifestyle. Yet, the myth of rugged individualism is strong and persistent.

The reality for all of us is that none survive or flourish without the help of others. Whether it is within a family, peer group, school, religious institution, or wider community, all of us have been helped by others. Someone somewhere encouraged us, gave us a break or an opportunity, however small.  Some have experienced random acts of kindness from strangers. The myth of rugged individualism, which often means “pulling yourself up by your own bootstraps,” is outdated, was never completely accurate, and is harming us.

Holding tightly to this myth leads to the misperception that an individual can do (or not do) whatever they want in society and no person or, perhaps especially, government entity can tell them otherwise. People say, “As long as my choice doesn’t harm anyone else, I should be able to do what I want.” How they know their action does not harm anyone else is unclear and there are examples from the pandemic where personal choice does harm others. In bioethics we recognize this view as an expression of individual autonomy; the freedom to govern oneself.  Yet, such blinkered views of individual autonomy are misguided and inaccurate. Everyone’s autonomy is limited in society to avoid harm to the self or others. We enforce seatbelt and drunk driving laws to these ends. Moreover, that we rely on others to function in society has been made very clear during the pandemic. We need others to provide food and education, collect our garbage, and conduct the scientific research that informs our knowledge of the virus. These contributions support the common good.

We have seen rugged individualism on full display during the coronavirus pandemic. It can lead to a disregard for the worth and value of others. While many people observed public health restrictions and guidelines, others, including some elected officials, refused to wear masks and are now refusing vaccination. Those who cling to their individualism seem to view such restrictions as unnecessary or unacceptable, an infringement on their individual rights and freedoms. They are not willing to sacrifice a degree of their freedom to protect themselves or others. The result has been 33,264,650 cases and 594,568 deaths in the United States and counting. 

Thursday, June 24, 2021

Updated Physician-Aid-in-Dying Law Sparks Controversy in Canada

Richard Karel
Psychiatric News
Originally posted 27 May 21

Here is an excerpt:

Addressing the changes for people who may be weighing MAID for severe mental illness, the government stated the following:

“If you have a mental illness as your only medical condition, you are not eligible to seek medical assistance in dying. … This temporary exclusion allows the Government of Canada more time to consider how MAID can safely be provided to those whose only medical condition is mental illness.

“To support this work, the government will initiate an expert review to consider protocols, guidance, and safeguards for those with a mental illness seeking MAID and will make recommendations within a year (by March 17, 2022).

“After March 17, 2023, people with a mental illness as their sole underlying medical condition will have access to MAID if they are eligible and the practitioners fulfill the safeguards that are put in place for this group of people. …”

While many physicians and others have long been sympathetic to allowing medical professionals to help those with terminal illness die peacefully, the fear has been that medically assisted death could become a substitute for adequate—and more costly—medical care. Those concerns are growing with the expansion of MAID in Canada.

Wednesday, June 23, 2021

Experimental Regulations for AI: Sandboxes for Morals and Mores

Ranchordas, Sofia
Morals and Machines (vol.1, 2021)
Available at SSRN: 

Abstract

Recent EU legislative and policy initiatives aim to offer flexible, innovation-friendly, and future-proof regulatory frameworks. Key examples are the EU Coordinated Plan on AI and the recently published EU AI Regulation Proposal which refer to the importance of experimenting with regulatory sandboxes so as to balance innovation in AI against its potential risks. Originally developed in the Fintech sector, regulatory sandboxes create a testbed for a selected number of innovative projects, by waiving otherwise applicable rules, guiding compliance, or customizing enforcement. Despite the burgeoning literature on regulatory sandboxes and the regulation of AI, the legal, methodological, and ethical challenges of regulatory sandboxes have remained understudied. This exploratory article delves into the some of the benefits and intricacies of employing experimental legal instruments in the context of the regulation of AI. This article’s contribution is twofold: first, it contextualizes the adoption of regulatory sandboxes in the broader discussion on experimental approaches to regulation; second, it offers a reflection on the steps ahead for the design and implementation of AI regulatory sandboxes.

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In conclusion, AI regulatory sandboxes are not the answer to more innovation in AI. They are part of the path to a more forward-looking approach to the interaction between law and technology. This new approach will most certainly be welcomed with reluctance in years to come as it disrupts existing dogmas pertaining to the way in which we conceive the principle of legal certainty and the reactive—rather than anticipatory—nature of law. However, traditional law and regulation were designed with human agents and enigmas in mind. Many of the problems generated by AI (discrimination, power asymmetries, and manipulation) are still human but their scale and potential for harms (and benefits) have long ceased to be. It is thus time to rethink our fundamental approach to regulation and refocus on the new regulatory subject before us.

Tuesday, June 22, 2021

Against Empathy Bias: The Moral Value of Equitable Empathy

Fowler, Z., Law, K. F., & Gaesser, B.
Psychological Science
Volume: 32 issue: 5, page(s): 766-779

Abstract

Empathy has long been considered central in living a moral life. However, mounting evidence has shown that empathy is often biased towards (i.e., felt more strongly for) close and similar others, igniting a debate over whether empathy is inherently morally flawed and should be abandoned in efforts to strive towards greater equity. This debate has focused on whether empathy limits the scope of our morality, with little consideration of whether it may be our moral beliefs limiting our empathy. Across two studies conducted on Amazon’s Mechanical Turk (N= 604), we investigate moral judgments of biased and equitable feelings of empathy. We observed a moral preference for empathy towards socially close over distant others. However, feeling equal empathy for all is seen as the most morally and socially valuable. These findings provide new theoretical insight into the relationship between empathy and morality with implications for navigating towards a more egalitarian future.

General Discussion

The present studies investigated moral judgments of socially biased and equitable feelings of empathy in hypothetical vignettes. The results showed that moral judgments of empathy are biased towards preferring more empathy for a socially close over socially distant individual. Despite this bias in moral judgments, however, people consistently judged feeling equal empathy as the most morally right. These findings generalized from judgments of others’ empathy for targets matched on objective social distance to judgments of one’s own empathy for targets that were personally-tailored and matched on subjective social distance across subjects.  Further, participants most desired to affiliate with someone who felt equal empathy. We also found that participants’ desire to affiliate with the actor in the vignette mirrored their moral judgments of empathy.

Monday, June 21, 2021

Drug Overdose Deaths Up 30% in Pandemic Year, Government Data Show

Joyce Frieden
MedPage Today 
Originally published 1 June 2021

Mortality from all types of drug overdoses increased by a whopping 30% over a 1-year period, Nora Volkow, MD, director of the National Institute on Drug Abuse (NIDA), reported at the FDA Science Forum.

Data from the National Center for Health Statistics from October 2019 to October 2020 shows that mortality from overdoses from all types of drugs increased 30%, from 70,669 deaths in October 2019 to 91,862 deaths in October 2020, "and I think that that is a number that is very, very chilling," Volkow said at the forum. Among those overdose deaths in both years, more than half came from synthetic opiates -- "the most notable presence is fentanyl," she said. There was also a 46% increase in overdose deaths from other psychostimulants, mainly methamphetamine, and a 38% increase in deaths from cocaine overdoses.

Having any kind of substance use disorder (SUD) also affects the risk of getting COVID-19, she continued. According to a study done by Volkow and colleagues, "Regardless of the specific type of substance use disorder -- legal or illegal -- there was a significant increase in the likelihood of people that have a substance use disorder to become infected," she said. Their study, which included electronic health records from 7.5 million patients with an SUD diagnosis, found that patients with a recent SUD diagnosis -- within the past year -- were nearly nine times more likely to contract COVID-19 than patients without that diagnosis; for those with opioid use disorder in particular, their odds of contracting COVID were 10 times higher.

How relationships bias moral reasoning: Neural and self-report evidence

Berg, M. K., Kitayama, S., & Kross, E.
Journal of Experimental Social Psychology
Volume 95, July 2021, 104156

Abstract

Laws govern society, regulating people's behavior to create social harmony. Yet recent research indicates that when laws are broken by people we know and love, we consistently fail to report their crimes. Here we identify an expectancy-based cognitive mechanism that underlies this phenomenon and illustrate how it interacts with people's motivations to predict their intentions to report crimes. Using a combination of self-report and brain (ERP) measures, we demonstrate that although witnessing any crime violates people's expectations, expectancy violations are stronger when close (vs. distant) others commit crimes. We further employ an experimental-causal-chain design to show that people resolve their expectancy violations in diametrically opposed ways depending on their relationship to the transgressor. When close others commit crimes, people focus more on the individual (vs. the crime), which leads them to protect the transgressor. However, the reverse is true for distant others, which leads them to punish the transgressor. These findings highlight the sensitivity of early attentional processes to information about close relationships. They further demonstrate how these processes interact with motivation to shape moral decisions. Together, they help explain why people stubbornly protect close others, even in the face of severe crimes.

Highlights

• We used neural and self-report methods to explain people's reluctance to punish close others who act immorally.

• Close others acting immorally, and severe immoral acts, are highly unexpected.

• Expectancy violations interact with motivation to drive attention.

• For close others, people focus on the transgressor, which yields a more lenient response.

• For distant others, people focus on the immoral act, which yields a more punitive response.