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

Thursday, September 9, 2021

Neurodualism: People Assume that the Brain Affects the Mind more than the Mind Affects the Brain

Valtonen, J., Ahn, W., & Cimpian, A.
Cognitive Science

Abstract

People commonly think of the mind and the brain as distinct entities that interact, a view known as dualism.  At the same time, the public widely acknowledges that science attributes all mental phenomena to the workings of a material brain, a view at odds with dualism. How do people reconcile these conflicting perspectives? We propose that people distort claims about the brain from the wider culture to fit their dualist belief that minds and brains are distinct, interacting entities: Exposure to cultural discourse about the brain as the physical basis for the mind prompts people to posit that mind–brain interactions are asymmetric, such that the brain is able to affect the mind more than vice versa. We term this hybrid intuitive theory neurodualism. Five studies involving both thought experiments and naturalistic scenarios provided evidence of neurodualism among laypeople and, to some extent, even practicing psychotherapists. For example, lay participants reported that “a change in a person’s brain” is accompanied by “a change in the person’s mind” more often than vice versa. Similarly, when asked to imagine that “future scientists were able to alter exactly 25% of a person’s brain,” participants reported larger corresponding changes in the person’s mind than in the opposite direction. Participants also showed a similarly asymmetric pattern favoring the brain over the mind in naturalistic scenarios.  By uncovering people’s intuitive theories of the mind–brain relation, the results provide insights into societal phenomena such as the allure of neuroscience and common misperceptions of mental health treatments.

From the General Discussion

In all experiments and across several different tasks involving both thought experiments and naturalistic scenarios, untrained participants believed that interventions acting on the brain would affect the mind more than interventions acting on the mind would affect the brain, supporting our proposal. This causal asymmetry was strong and replicated reliably with untrained participants. Moreover, the extent to which participants endorsed popular dualism was only weakly correlated with their endorsement of neurodualism, supporting our proposal that a more complex set of beliefs is involved. In the last study, professional psychotherapists also showed evidence of endorsing neurodualism—albeit to a weaker degree—despite their scientific training and their stronger reluctance, relative to lay participants, to believe that psychiatric medications affect the mind.

Our results both corroborate and extend prior findings regarding intuitive reasoning about minds and brains. Our results corroborate prior findings by showing, once again, that both lay people and trained mental health professionals commonly hold dualistic beliefs. If their reasoning had been based on (folk versions of) a physicalist model such as identity theory or supervenience, participants should not have expected mental events to occur in the absence of neural events. However, both lay participants and professional psychotherapists did consistently report that mental changes can occur (at least sometimes) even in situations in which no neural changes occur. (Underline inserted for emphasis.)

Wednesday, September 8, 2021

America Runs on ‘Dirty Work’ and Moral Inequality

Eyal Press
The New York Times
Originally posted 13 Aug 21

Here is an excerpt:

“Dirty work” can refer to any unpleasant job, but among social scientists, the term has a more pointed meaning. In 1962, Everett Hughes, an American sociologist, published an essay titled “Good People and Dirty Work” that drew on conversations he’d had in postwar Germany about the mass atrocities of the Nazi era. Mr. Hughes argued that the persecution of Jews proceeded with the unspoken assent of many supposedly enlightened Germans, who refrained from asking too many questions because, on some level, they were not entirely displeased.

This was the nature of dirty work as Mr. Hughes conceived of it: unethical activity that was delegated to certain agents and then disavowed by society, even though the perpetrators had an “unconscious mandate” from their fellow citizens. As extreme as the Nazi example was, this dynamic existed in every society, Mr. Hughes wrote, enabling respectable citizens to distance themselves from the morally troubling things being done in their name. The dirty workers were not rogue actors but “agents” of “good people” who passively stood by.

Contemporary America runs on dirty work. Some of the people who do this work are our agents by virtue of the fact that they perform public functions, such as running the world’s largest penal system. Others qualify as such by catering to our consumption habits — the food we eat, the fossil fuels we burn, which are drilled and fracked by dirty workers in places like the Gulf of Mexico. The high-tech gadgets in our pockets rely on yet another form of dirty work — the mining of cobalt — that has been outsourced to workers in Africa and to foreign subcontractors that often brutally exploit them.

Like the essential jobs performed by grocery clerks and other low-wage workers during the Covid-19 pandemic, this work sustains our lifestyles and undergirds the prevailing social order, but privileged people are generally spared from having to think about it. One reason is that the dirty work occurs far away from them, in isolated institutions — prisons, slaughterhouses — that are closed to the public. Another reason is that the privileged rarely have to do it. Although there is no shortage of it to go around, dirty work in America is not randomly distributed. 

Tuesday, September 7, 2021

Vaccination as a social contract

L. Korn, et al.
PNASJun 2020, 117 (26) 
14890-14899; 
DOI: 10.1073/pnas.1919666117

Abstract

Most vaccines protect both the vaccinated individual and the society by reducing the transmission of infectious diseases. In order to eliminate infectious diseases, individuals need to consider social welfare beyond mere self-interest—regardless of ethnic, religious, or national group borders. It has therefore been proposed that vaccination poses a social contract in which individuals are morally obliged to get vaccinated. However, little is known about whether individuals indeed act upon this social contract. If so, vaccinated individuals should reciprocate by being more generous to a vaccinated other. On the contrary, if the other doesn’t vaccinate and violates the social contract, generosity should decline. Three preregistered experiments investigated how a person’s own vaccination behavior, others’ vaccination behavior, and others’ group membership influenced a person’s generosity toward respective others. The experiments consistently showed that especially compliant (i.e., vaccinated) individuals showed less generosity toward nonvaccinated individuals. This effect was independent of the others’ group membership, suggesting an unconditional moral principle. An internal metaanalysis (n = 1,032) confirmed the overall social contract effect. In a fourth experiment (n = 1,212), this pattern was especially pronounced among vaccinated individuals who perceived vaccination as a moral obligation. It is concluded that vaccination is a social contract in which cooperation is the morally right choice. Individuals act upon the social contract, and more so the stronger they perceive it as a moral obligation. Emphasizing the social contract could be a promising intervention to increase vaccine uptake, prevent free riding, and, eventually, support the elimination of infectious diseases.

Significance

Vaccines support controlling and eliminating infectious diseases. As most vaccines protect both vaccinated individuals and the society, vaccination is a prosocial act. Its success relies on a large number of contributing individuals. We study whether vaccination is a social contract where individuals reciprocate and reward others who comply with the contract and punish those who don’t. Four preregistered experiments demonstrate that vaccinated individuals indeed show less generosity toward nonvaccinated individuals who violate the social contract. This effect is independent of whether the individuals are members of the same or different social groups. Thus, individuals’ behavior follows the rules of a social contract, which provides a valuable basis for future interventions aiming at increasing vaccine uptake by emphasizing this social contract.

Monday, September 6, 2021

Paranoia and belief updating during the COVID-19 crisis

Suthaharan, P., Reed, E.J., Leptourgos, P. et al. 
Nat Hum Behav (2021). 
https://doi.org/10.1038/s41562-021-01176-8

Abstract

The COVID-19 pandemic has made the world seem less predictable. Such crises can lead people to feel that others are a threat. Here, we show that the initial phase of the pandemic in 2020 increased individuals’ paranoia and made their belief updating more erratic. A proactive lockdown made people’s belief updating less capricious. However, state-mandated mask-wearing increased paranoia and induced more erratic behaviour. This was most evident in states where adherence to mask-wearing rules was poor but where rule following is typically more common. Computational analyses of participant behaviour suggested that people with higher paranoia expected the task to be more unstable. People who were more paranoid endorsed conspiracies about mask-wearing and potential vaccines and the QAnon conspiracy theories. These beliefs were associated with erratic task behaviour and changed priors. Taken together, we found that real-world uncertainty increases paranoia and influences laboratory task behaviour.

Discussion

The COVID-19 pandemic has been associated with increased paranoia. The increase was less pronounced in states that enforced a more proactive lockdown and more pronounced at reopening in states that mandated mask-wearing. Win-switch behaviour and volatility priors tracked these changes in paranoia with policy. We explored cultural variations in rule following (CTL) as a possible contributor to the increased paranoia that we observed. State tightness may originate in response to threats such as natural disasters, disease, territorial and ideological conflict. Tighter states typically evince more coordinated threat responses. They have also experienced greater mortality from pneumonia and influenza throughout their history. However, paranoia was highest in tight states with a mandate, with lower mask adherence during reopening. It may be that societies that adhere rigidly to rules are less able to adapt to unpredictable change. Alternatively, these societies may prioritize protection from ideological and economic threats over a public health crisis or perhaps view the disease burden as less threatening.

Sunday, September 5, 2021

A Just Standard: The Ethical Management of Incidental Findings in Brain Imaging Research

Graham, M., Hallowell, N., & Savulescu, J. (2021). 
Journal of Law, Medicine & Ethics, 49(2), 269-281. 
doi:10.1017/jme.2021.38

Abstract

Neuroimaging research regularly yields “incidental findings”: observations of potential clinical significance in healthy volunteers or patients, but which are unrelated to the purpose or variables of the study.

From the Conclusion

Appealing to considerations of distributive justice provides an answer for these difficult cases. Data about a patient’s brain that may be generated by a neuroimaging scan in a research context is not something a healthy participant is entitled to as a matter of basic care. Accordingly, a researcher has no obligation to generate this information by performing additional scans (i.e., to “look” for incidental findings). Similarly, if a researcher discovers an incidental finding of unknown or uncertain clinical significance, they are not required to refer a participant for follow-up. Screening for brain abnormalities is not a requirement of basic care, and the burdens of follow-up on the health system (given the potential benefits) are inconsistent with distributive justice. This approach thus avoids the problem of trying to determine whether disclosure (is likely to) promote autonomy or benefit the patient. Rather, it requires researchers to ensure that participants are not deprived of anything to which they are entitled as a matter of distributive justice. This includes all of the protections to which participants in research are normally entitled, as well as the disclosure of clinically significant incidental findings.

Saturday, September 4, 2021

Dilemma 39: Pills, Chills, but No Thrills

Dr. Janssen has been treating Eli Lily for the past year.  During a recent session, Mr. Lily stated that he had been having financial problems.  When queried by Dr. Janssen, Mr. Lily detailed that he can sell his medication to co-workers and neighbors.  Dr. Janssen asked a few other questions, then Mr. Lily changed the subject.  While writing notes, Dr. Janssen reviewed note from the initial intake.  Mr. Lily takes a variety of controlled substances, including Adderall for ADHD and Ambien for insomnia.  Mr. Lily receives these prescriptions for Adderall and Ambien, as well as other medication, from his physician’s associate (PA). 

At the next session, Dr. Janssen asked more questions about the medications he had been selling.  Mr. Lily reported he sells Adderall and Ambien intermittently.  However, Mr. Lily has had a medical marijuana card and has being selling various forms of medical marijuana on a regular basis to friends and family.  Mr. Lily obtained a medical marijuana card through a process independent of the PA, and indicated the PA does not know about the medical marijuana.

Dr. Janssen in clearly concerned about these legal and clinical issues.  Dr. Janssen wants to just forget he asked these questions, but calls you for a consultation.

What are the ethical issues involved in this case?

What are the clinical issues involved in this situation?

What are the ramifications about the therapeutic relationship?

What courses of action would you suggest to Dr. Janssen?

Friday, September 3, 2021

What is consciousness, and could machines have it?

S. Dahaene, H. Lau, & S. Kouider
Science  27 Oct 2017:
Vol. 358, Issue 6362, pp. 486-492

Abstract

The controversial question of whether machines may ever be conscious must be based on a careful consideration of how consciousness arises in the only physical system that undoubtedly possesses it: the human brain. We suggest that the word “consciousness” conflates two different types of information-processing computations in the brain: the selection of information for global broadcasting, thus making it flexibly available for computation and report (C1, consciousness in the first sense), and the self-monitoring of those computations, leading to a subjective sense of certainty or error (C2, consciousness in the second sense). We argue that despite their recent successes, current machines are still mostly implementing computations that reflect unconscious processing (C0) in the human brain. We review the psychological and neural science of unconscious (C0) and conscious computations (C1 and C2) and outline how they may inspire novel machine architectures.

From Concluding remarks

Our stance is based on a simple hypothesis: What we call “consciousness” results from specific types of information-processing computations, physically realized by the hardware of the brain. It differs from other theories in being resolutely computational; we surmise that mere information-theoretic quantities do not suffice to define consciousness unless one also considers the nature and depth of the information being processed.

We contend that a machine endowed with C1 and C2 would behave as though it were conscious; for instance, it would know that it is seeing something, would express confidence in it, would report it to others, could suffer hallucinations when its monitoring mechanisms break down, and may even experience the same perceptual illusions as humans. Still, such a purely functional definition of consciousness may leave some readers unsatisfied. Are we “over-intellectualizing” consciousness, by assuming that some high-level cognitive functions are necessarily tied to consciousness? Are we leaving aside the experiential component (“what it is like” to be conscious)? Does subjective experience escape a computational definition?

Although those philosophical questions lie beyond the scope of the present paper, we close by noting that empirically, in humans the loss of C1 and C2 computations covaries with a loss of subjective experience. 

Thursday, September 2, 2021

Reconciling scientific and commonsense values to improve reasoning

C. Cusimano & T. Lombrozo
Trends in Cognitive Sciences
Available online July 2021

Abstract

Scientific reasoning is characterized by commitments to evidence and objectivity. New research suggests that under some conditions, people are prone to reject these commitments, and instead sanction motivated reasoning and bias. Moreover, people’s tendency to devalue scientific reasoning likely explains the emergence and persistence of many biased beliefs. However, recent work in epistemology has identified ways in which bias might be legitimately incorporated into belief formation. Researchers can leverage these insights to evaluate when commonsense affirmation of bias is justified and when it is unjustified and therefore a good target for intervention.

Highlights
  • People espouse a ‘lay ethics of belief’ that defines standards for how beliefs should be evaluated and formed.
  • People vary in the extent to which they endorse scientific norms of reasoning, such as evidentialism and impartiality, in their own norms of belief. In some cases, people sanction motivated or biased thinking.
  • Variation in endorsement of scientific norms predicts belief accuracy, suggesting that interventions that target norms could lead to more accurate beliefs.
  • Normative theories in epistemology vary in whether, and how, they regard reasoning and belief formation as legitimately impacted by moral or pragmatic considerations.
  • Psychologists can leverage knowledge of people’s lay ethics of belief, and normative arguments about when and whether bias is appropriate, to develop interventions to improve reasoning that are both ethical and effective.

Concluding remarks

It is no secret that humans are biased reasoners. Recent work suggests that these departures from scientific reasoning are not simply the result of unconscious bias, but are also a consequence of endorsing norms for belief that place personal, moral, or social good above truth.  The link between devaluing the ‘scientific ethos’ and holding biased beliefs suggests that, in some cases, interventions on the perceived value of scientific reasoning could lead to better reasoning and to better outcomes. In this spirit, we have offered a strategy for value debiasing.

Wednesday, September 1, 2021

The Dynamics of Inattention in the (Baseball) Field

J. E. Archsmith, et al. 
IZA Institute of Labor Economics
June 2021

Abstract

Recent theoretical and empirical work characterizes attention as a limited resource that decision-makers strategically allocate. There has been less research on the dynamic interdependence of attention: how paying attention now may affect performance later. In this paper, we exploit high-frequency data on decision-making by Major League Baseball umpires to examine this. We find that umpires not only apply greater effort to higher stakes decisions, but also that effort applied to earlier decisions increases errors later. These findings are consistent with the umpire having a depletable ‘budget’ of attention. There is no such dynamic interdependence after breaks during the game (at the end of each inning) suggesting that even short rest periods can replenish attention budgets. We also find that an expectation of higher stakes future decisions leads to reduced attention to current decisions, consistent with forward-looking behavior by umpires aware of attention scarcity.

Conclusions

Conventional economic models embody agents able to make perfect, optimising decisions.  An important strand of recent efforts to increase the behavioral realism of models has been to acknowledge that attention is not costless---the effort required to attend to decisions and execute them well can be costly and cognitively tiring---and incorporate that in models. Models of “strategic inattention”, predicated on rational agents adjusting their behavior to account for attention being either limited and/or costly, are increasingly mainstream (for examples Caplin and Dean, 2015; Sims, 2003; Falkinger, 2011).

While the idea of costly attention is intuitively appealing, rigorous evidence characterizing its implications in real settings remains limited and primarily focuses on static effects in cross sectional data. This paper adds to and extends this evidence. Studying the quality of decisions made by a panel of professional decision-makers with strong incentives to get these decisions right, we show that MLB umpires systematically vary the effort they apply to individual decisions: applying greater attention to those associated with higher stakes. This is consistent with established theoretical models of strategic inattention. Our data-rich setting, in which the same umpire is called upon to issue a long series of decisions, allows for careful study of the dynamics of inattention and delivers our most novel results.