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

Tuesday, July 27, 2021

Forms and Functions of the Social Emotions

Sznycer, D., Sell, A., & Lieberman, D. (2021). 
Current Directions in Psychological Science. 
https://doi.org/10.1177/09637214211007451

Abstract

In engineering, form follows function. It is therefore difficult to understand an engineered object if one does not examine it in light of its function. Just as understanding the structure of a lock requires understanding the desire to secure valuables, understanding structures engineered by natural selection, including emotion systems, requires hypotheses about adaptive function. Social emotions reliably solved adaptive problems of human sociality. A central function of these emotions appears to be the recalibration of social evaluations in the minds of self and others. For example, the anger system functions to incentivize another individual to value your welfare more highly when you deem the current valuation insufficient; gratitude functions to consolidate a cooperative relationship with another individual when there are indications that the other values your welfare; shame functions to minimize the spread of discrediting information about yourself and the threat of being devalued by others; and pride functions to capitalize on opportunities to become more highly valued by others. Using the lens of social valuation, researchers are now mapping these and other social emotions at a rapid pace, finding striking regularities across industrial and small-scale societies and throughout history.

From the Shame portion

The behavioral repertoire of shame is broad. From the perspective of the disgraced or to-be-disgraced individual, a trait (e.g., incompetence) or course of action (e.g., theft) that fellow group members view negatively can be shielded from others’ censure at each of various junctures: imagination, decision making, action, information diffusion within the community, and audience reaction. Shame appears to have authority over devaluation-minimizing responses relevant to each of these junctures. For example, shame can lead people to turn away from courses of actions that might lead others to devalue them, to interrupt their execution of discrediting actions, to conceal and destroy reputationally damaging information about themselves, and to hide. When an audience finds discrediting information about the focal individual and condemns or attacks that individual, the shamed individual may apologize, signal submission, appease, cooperate, obfuscate, lie, shift the blame to others, or react with aggression. These behaviors are heterogeneous from a tactical standpoint; some even work at cross-purposes if mobilized concurrently. But each of these behaviors appears to have the strategic potential to limit the threat of devaluation in certain contexts, combinations, or sequences.

Such shame-inspired behaviors as hiding, scapegoating, and aggressing are undesirable from the standpoint of victims and third parties. This has led to the view that shame is an ugly and maladaptive emotion (Tangney et al., 1996). However, note that those behaviors can enhance the welfare of the focal individual, who is pressed to escape detection and minimize or counteract devaluation by others. Whereas the consequences of social devaluation are certainly ugly for the individual being devalued, the form-function approach suggests instead that shame is an elegantly engineered system that transmits bad news of the potential for devaluation to the array of counter-devaluation responses available to the focal individual.


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Important data points to share with trainees.  A good refreshed for seasoned therapists.

Monday, July 26, 2021

Do doctors engaging in advocacy speak for themselves or their profession?

Elizabeth Lanphier
Journal of Medical Ethics Blog
Originally posted 17 June 21

Here is an excerpt:

My concern is not the claim that expertise should be shared. (It should!) Nor do I think there is any neat distinction between physician responsibilities for individual health and public health. But I worry that when Strous and Karni alternately frame physician duties to “speak out” as individual duties and collective ones, they collapse necessary distinctions between the risks, benefits, and demands of these two types of obligations.

Many of us have various role-based individual responsibilities. We can have obligations as a parent, as a citizen, or as a professional. Having an individual responsibility as a physician involves duties to your patients, but also general duties to care in the event you are in a situation in which your expertise is needed (the “is there a doctor on this flight?” scenario).

Collective responsibility, on the other hand, is when a group has a responsibility as a group. The philosophical literature debates hard to resolve questions about what it means to be a “group,” and how groups come to have or discharge responsibilities. Collective responsibility raises complicated questions like: If physicians have a collective responsibility to speak out during the COVID-19 pandemic, does every physician has such an obligation? Does any individual physician?

Because individual obligations attribute duties to specific persons responsible for carrying them out in ways collective duties tend not to, I why individual physician obligations are attractive. But this comes with risks. One risk is that a physician speaks out as an individual, appealing to the authority of their medical credentials, but not in alignment with their profession.

In my essay I describe a family physician inviting his extended family for a holiday meal during a peak period of SARS-CoV-2 transmission because he didn’t think COVID-19 was a “big deal.”

More infamously, Dr. Scott Atlas served as Donald J. Trump’s coronavirus advisor, and although he is a physician, he did not have experience in public health, infectious disease, or critical care medicine applicable to COVID-19. Atlas was a physician speaking as a physician, but he routinely promoted views starkly different than those of physicians with expertise relevant to the pandemic, and the guidance coming from scientific and medical communities.

Sunday, July 25, 2021

Should we be concerned that the decisions of AIs are inscrutable?

John Zerilli
Psyche.co
Originally published 14 June 21

Here is an excerpt:

However, there’s a danger of carrying reliabilist thinking too far. Compare a simple digital calculator with an instrument designed to assess the risk that someone convicted of a crime will fall back into criminal behaviour (‘recidivism risk’ tools are being used all over the United States right now to help officials determine bail, sentencing and parole outcomes). The calculator’s outputs are so dependable that an explanation of them seems superfluous – even for the first-time homebuyer whose mortgage repayments are determined by it. One might take issue with other aspects of the process – the fairness of the loan terms, the intrusiveness of the credit rating agency – but you wouldn’t ordinarily question the engineering of the calculator itself.

That’s utterly unlike the recidivism risk tool. When it labels a prisoner as ‘high risk’, neither the prisoner nor the parole board can be truly satisfied until they have some grasp of the factors that led to it, and the relative weights of each factor. Why? Because the assessment is such that any answer will necessarily be imprecise. It involves the calculation of probabilities on the basis of limited and potentially poor-quality information whose very selection is value-laden.

But what if systems such as the recidivism tool were in fact more like the calculator? For argument’s sake, imagine a recidivism risk-assessment tool that was basically infallible, a kind of Casio-cum-Oracle-of-Delphi. Would we still expect it to ‘show its working’?

This requires us to think more deeply about what it means for an automated decision system to be ‘reliable’. It’s natural to think that such a system would make the ‘right’ recommendations, most of the time. But what if there were no such thing as a right recommendation? What if all we could hope for were only a right way of arriving at a recommendation – a right way of approaching a given set of circumstances? This is a familiar situation in law, politics and ethics. Here, competing values and ethical frameworks often produce very different conclusions about the proper course of action. There are rarely unambiguously correct outcomes; instead, there are only right ways of justifying them. This makes talk of ‘reliability’ suspect. For many of the most morally consequential and controversial applications of ML, to know that an automated system works properly just is to know and be satisfied with its reasons for deciding.

Saturday, July 24, 2021

Freezing Eggs and Creating Patients: Moral Risks of Commercialized Fertility

E. Reis & S. Reis-Dennis
The Hastings Center Report
Originally published 24 Nov 17

Abstract

There's no doubt that reproductive technologies can transform lives for the better. Infertile couples and single, lesbian, gay, intersex, and transgender people have the potential to form families in ways that would have been inconceivable years ago. Yet we are concerned about the widespread commercialization of certain egg-freezing programs, the messages they propagate about motherhood, the way they blur the line between care and experimentation, and the manipulative and exaggerated marketing that stretches the truth and inspires false hope in women of various ages. We argue that although reproductive technology, and egg freezing in particular, promise to improve women's care by offering more choices to achieve pregnancy and childbearing, they actually have the potential to be disempowering. First, commercial motives in the fertility industry distort women's medical deliberations, thereby restricting their autonomy; second, having the option to freeze their eggs can change the meaning of women's reproductive choices in a way that is limiting rather than liberating.

Here is an excerpt:

Egg banks are offering presumably fertile women a solution for potential infertility that they may never face. These women might pay annual egg-freezing storage rates but never use their eggs. In fact, even if a woman who froze eggs in her early twenties waited until her late thirties to use them, there can be no guarantee that those eggs would produce a viable pregnancy. James A. Grifo, program director of NYU Langone Health Fertility Center, has speculated, “[T]here have been reports of embryos that have been frozen for over 15 years making babies, and we think the same thing is going to be true of eggs.” But the truth is that the technology is so new that neither he nor we know how frozen eggs will hold up over a long period of time.

Some women in their twenties might want to hedge their bets against future infertility by freezing their eggs as a part of an egg-sharing program; others might hope to learn from a simple home test of hormone levels whether their egg supply (ovarian reserve) is low—a relatively rare condition. However, these tests are not foolproof. The ASRM has cautioned against home tests of ovarian reserve for women in their twenties because it may lead to “false reassurance or unnecessary anxiety and concern.” This kind of medicalization of fertility may not be liberating; instead, it will exert undue pressure on women and encourage them to rely on egg freezing over other reproductive options when it is far from guaranteed that those frozen eggs (particularly if the women have the condition known as premature ovarian aging) will ultimately lead to successful pregnancies and births.

Friday, July 23, 2021

Women Carry An Undue Mental Health Burden. They Shouldn’t Have To

Rawan Hamadeh
Ms. Magazine
Originally posted 12 June 21

Here is an excerpt:

In developing countries, there is a huge gap in the availability and accessibility of specialized mental health services. Rather than visiting mental health specialists, women are more likely to seek mental health support in primary health care settings while accompanying their children or while attending consultations for other health issues. This leads to many mental health conditions going unidentified and therefore not treated. Often, women do not feel fully comfortable disclosing certain psychological and emotional distress because they fear stigmatization, confidentiality breaches or not being taken seriously.

COVID-19 has put the mental well-being of the entire world at risk. More adults are reporting struggles with mental health and substance use and are experiencing more symptoms of anxiety and depressive disorders. The stressors caused by the pandemic have affected the entire population; however, the effect on women and mothers specifically has been greater.

Women, the unsung heroes of the pandemic, face mounting pressures amid this global health crisis. Reports suggest that the long-term repercussions of COVID-19 could undo decades of progress for women and impose considerable additional burdens on them, threatening the difficult journey toward gender equality.

Unemployment, parenting responsibilities, homeschooling or caring for sick relatives are all additional burdens on women’s daily lives during the pandemic. It’s also important that we acknowledge the exponential need for mental health support for health care workers, and particularly health care mothers, who are juggling both their professional duties and their parenting responsibilities. They are the heroes on the front lines of the fight against the virus, and it’s crucial to prioritize their physical as well as their mental health.

Thursday, July 22, 2021

The Possibility of an Ongoing Moral Catastrophe

Williams, E.G. (2015).
Ethic Theory Moral Prac 18, 
971–982 (2015). 
https://doi.org/10.1007/s10677-015-9567-7

Abstract

This article gives two arguments for believing that our society is unknowingly guilty of serious, large-scale wrongdoing. First is an inductive argument: most other societies, in history and in the world today, have been unknowingly guilty of serious wrongdoing, so ours probably is too. Second is a disjunctive argument: there are a large number of distinct ways in which our practices could turn out to be horribly wrong, so even if no particular hypothesized moral mistake strikes us as very likely, the disjunction of all such mistakes should receive significant credence. The article then discusses what our society should do in light of the likelihood that we are doing something seriously wrong: we should regard intellectual progress, of the sort that will allow us to find and correct our moral mistakes as soon as possible, as an urgent moral priority rather than as a mere luxury; and we should also consider it important to save resources and cultivate flexibility, so that when the time comes to change our policies we will be able to do so quickly and smoothly.

Wednesday, July 21, 2021

The Parliamentary Approach to Moral Uncertainty

Toby Newberry & Toby Ord
Future of Humanity Institute
University of Oxford 2021

Abstract

We introduce a novel approach to the problem of decision-making under moral uncertainty, based
on an analogy to a parliament. The appropriate choice under moral uncertainty is the one that
would be reached by a parliament comprised of delegates representing the interests of each moral
theory, who number in proportion to your credence in that theory. We present what we see as the
best specific approach of this kind (based on proportional chances voting), and also show how the
parliamentary approach can be used as a general framework for thinking about moral uncertainty,
where extant approaches to addressing moral uncertainty correspond to parliaments with different
rules and procedures.

Here is an excerpt:

Moral Parliament

Imagine that each moral theory in which you have credence got to send delegates to an internal parliament, where the number of delegates representing each theory was proportional to your credence in that theory. Now imagine that these delegates negotiate with each other, advocating on behalf of their respective moral theories, until eventually the parliament reaches a decision by the delegates voting on the available options. This would provide a novel approach to decision-making under moral uncertainty that may avoid some of the problems that beset the others, and it may even provide a new framework for thinking about moral uncertainty more broadly.

(cut)

Here, we endorse a common-sense approach to the question of scale which has much in common with standard decision-theoretic conventions. The suggestion is that one should convene Moral Parliament for those decision-situations to which it is intuitively appropriate, such as those involving non-trivial moral stakes, where the possible options are relatively well-defined, and so on. Normatively speaking, if Moral Parliament is the right approach to take to moral uncertainty, then it may also be right to apply it to all decision-situations (however this is defined). But practically speaking, this would be very difficult to achieve. This move has essentially the same implications as the approach of sidestepping the question but comes with a positive endorsement of Moral Parliament’s application to ‘the kinds of decision-situations typically described in papers on moral uncertainty’. This is the sense in which the common-sense approach resembles standard decision-theoretic conventions. 

Tuesday, July 20, 2021

Morally Motivated Networked Harassment as Normative Reinforcement

Marwick, A. E. (2021). 
Social Media + Society. 

Abstract

While online harassment is recognized as a significant problem, most scholarship focuses on descriptions of harassment and its effects. We lack explanations of why people engage in online harassment beyond simple bias or dislike. This article puts forth an explanatory model where networked harassment on social media functions as a mechanism to enforce social order. Drawing from examples of networked harassment taken from qualitative interviews with people who have experienced harassment (n = 28) and Trust & Safety workers at social platforms (n = 9), the article builds on Brady, Crockett, and Bavel’s model of moral contagion to explore how moral outrage is used to justify networked harassment on social media. In morally motivated networked harassment, a member of a social network or online community accuses a target of violating their network’s norms, triggering moral outrage. Network members send harassing messages to the target, reinforcing their adherence to the norm and signaling network membership. Frequently, harassment results in the accused self-censoring and thus regulates speech on social media. Neither platforms nor legal regulations protect against this form of harassment. This model explains why people participate in networked harassment and suggests possible interventions to decrease its prevalence.

From the Conclusion

Ultimately, conceptualizing harassment as morally motivated and understanding it as a technique of norm reinforcement explains why people participate in it, a necessary step to decreasing it. This model may open creative solutions to harassment and content moderation. MMNH also recognizes that harassment, while more endemic to minorized communities, may be experienced by people from a wide variety of identities and political commitments, suggesting many possibilities for future research. Current technical and legal models of harassment do not protect against networked harassment; by providing a new model, I hope to contribute to lessening its prevalence.

Monday, July 19, 2021

Non-consensual personified sexbots: an intrinsic wrong

Lancaster, K. 
Ethics Inf Technol (2021). 

Abstract

Humanoid robots used for sexual purposes (sexbots) are beginning to look increasingly lifelike. It is possible for a user to have a bespoke sexbot created which matches their exact requirements in skin pigmentation, hair and eye colour, body shape, and genital design. This means that it is possible—and increasingly easy—for a sexbot to be created which bears a very high degree of resemblance to a particular person. There is a small but steadily increasing literature exploring some of the ethical issues surrounding sexbots, however sexbots made to look like particular people is something which, as yet, has not been philosophically addressed in the literature. In this essay I argue that creating a lifelike sexbot to represent and resemble someone is an act of sexual objectification which morally requires consent, and that doing so without the person’s consent is intrinsically wrong. I consider two sexbot creators: Roy and Fred. Roy creates a sexbot of Katie with her consent, and Fred creates a sexbot of Jane without her consent. I draw on the work of Alan Goldman, Rae Langton, and Martha Nussbaum in particular to demonstrate that creating a sexbot of a particular person requires consent if it is to be intrinsically permissible.

From the Conclusion

Although sexbots may bring about a multitude of negative consequences for individuals and society, I have set these aside in order to focus on the intrinsically wrong act of creating a personified sexbot without the consent of the human subject. I have maintained that creating a personified sexbot is an act of sexual objectification directed towards that particular person which may or may not be permissible, depending on whether the human subject’s consent was obtained. Using Nussbaum’s Kantian-inspired argument, I have shown that non-consensually sexbotifying a human subject involves using them merely as a means, which is intrinsically wrong. Meanwhile, in a sexbotification case where the human subject’s prior consent is obtained, she has not been intrinsically wronged by the creation of the sexbot because she has not been used merely as a means to an end. With personified sexbots, consent of the human subject is a moral prerequisite, and is transformative when obtained. In other words, in cases of non-consensual sexbotification, the lack of consent is the wrong-making feature of the act. Even if it were the case that creating any sexbot is intrinsically wrong because it objectifies women qua women, it is still right to maintain that sexbotifying a woman without her consent is an additional intrinsic wrong.