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

Saturday, December 18, 2021

U.S. judge tosses $4.5 B deal shielding Sacklers from opioid lawsuits

Brendan Pierson & Mike Spector, Maria Chutchian
Reuters
Originally posted 16 DEC 21

A federal judge overturned a roughly $4.5 billion settlement that legally shielded members of the Sackler family who stand accused of helping fuel the U.S. opioid epidemic, a decision that threatened to upend the bankruptcy reorganization of their company, OxyContin maker Purdue Pharma LP.

U.S. District Judge Colleen McMahon said in a written opinion on Thursday the New York bankruptcy court that approved the settlement did not have authority to grant the Sacklers the legal protection from future opioid litigation that formed the linchpin of Purdue’s reorganization.

Purdue said it would appeal the decision.

"While the district court decision does not affect Purdue’s rock-solid operational stability or its ability to produce its many medications safely and effectively, it will delay, and perhaps end, the ability of creditors, communities, and individuals to receive billions in value to abate the opioid crisis," Purdue Chairman Steve Miller said in a statement.

The Sacklers had insisted on the legal shields, known as nondebtor releases because they protect parties that have not filed for bankruptcy themselves, in exchange for contributing $4.5 billion toward resolving widespread opioid litigation.

The Sacklers threatened to walk away from the settlement absent the guaranteed legal protections.

Representatives for the Sacklers did not immediately respond to a request for comment late on Thursday.

Attorney General Merrick Garland said in a statement he was pleased with the ruling.

"The bankruptcy court did not have the authority to deprive victims of the opioid crisis of their right to sue the Sackler family," Garland said.


Note: If you have not watched Dopesick on Hulu, please do.  Excellent portrayal of the level of harm and psychopathology with members of this family.

Friday, December 17, 2021

The Conversational Circumplex: Identifying, Prioritizing, and Pursuing Informational and Relational Motives in Conversation

M. Yeomans, M. Schweitzer, & A. WoodBrooks
Current Opinion in Psychology
Available online 11 October 2021

Abstract

The meaning of success in conversation depends on people’s goals. Often, individuals pursue multiple goals simultaneously, such as establishing shared understanding, making a favorable impression, and persuading a conversation partner. In this article, we introduce a novel theoretical framework, the Conversational Circumplex, to classify conversational motives along two key dimensions: 1) Informational: the extent to which a speaker’s motive focuses on giving and/or receiving accurate information and 2) Relational: the extent to which a speaker’s motive focuses on building the relationship. We use the conversational circumplex to underscore the multiplicity of conversational goals that people hold, and highlight the potential for individuals to have conflicting conversational goals (both intrapersonally and interpersonally) that make successful conversation a difficult challenge.

Conclusion

In this article, we introduce a novel framework, the Conversational Circumplex, to build our understanding of conversational motives. By introducing this framework, we provide a generative foundation for future scholarship and a useful tool for conversationalists to identify their own motives, discern others’ motives, and advance their goals more effectively in conversation. The meaning of success in a conversation requires that we start by understanding what conversationalists are hoping to achieve.

Note: This has implications for psychotherapy and other helping relationships.

Thursday, December 16, 2021

The hidden ‘replication crisis’ of finance

Robin Wigglesworth 
Financial Times
Originally published 15 NOV 2021

Here is an excerpt:

Is investing suffering from something similar?

That is the incendiary argument of Campbell Harvey, professor of finance at Duke university. He reckons that at least half of the 400 supposedly market-beating strategies identified in top financial journals over the years are bogus. Worse, he worries that many fellow academics are in denial about this.

“It’s a huge issue,” he says. “Step one in dealing with the replication crisis in finance is to accept that there is a crisis. And right now, many of my colleagues are not there yet.”

Harvey is not some obscure outsider or performative contrarian attempting to gain attention through needless controversy. He is the former editor of the Journal of Finance, a former president of the American Finance Association, and an adviser to investment firms like Research Affiliates and Man Group.

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Obviously, the stakes of the replication crisis are much higher in medicine, where lives can be in play. But it is not something that remains confined to the ivory towers of business schools, as investment groups often smell an opportunity to sell products based on apparently market-beating factors, Harvey argues. “It filters into the real world,” he says. “It definitely makes it into people’s portfolios.”


Wednesday, December 15, 2021

Voice-hearing across the continuum: a phenomenology of spiritual voices

Moseley, P., et al. (2021, November 16).
https://doi.org/10.31234/osf.io/7z2at

Abstract

Voice-hearing in clinical and non-clinical groups has previously been compared using standardized assessments of psychotic experiences. Findings from several studies suggest that non-clinical voice-hearing (NCVH) is distinguished by reduced distress and increased control. However, symptom-rating scales developed for clinical populations may be limited in their ability to elucidate subtle and unique aspects of non-clinical voices. Moreover, such experiences often occur within specific contexts and systems of belief, such as spiritualism. This makes direct comparisons difficult to interpret. Here we present findings from a comparative interdisciplinary study which administered a semi-structured interview to NCVH individuals and psychosis patients. The non-clinical group were specifically recruited from spiritualist communities. The findings were consistent with previous results regarding distress and control, but also documented multiple modalities that were often integrated into a single entity, high levels of associated visual imagery, and subtle differences in the location of voices relating to perceptual boundaries. Most spiritual voice-hearers reported voices before encountering spiritualism, suggesting that their onset was not solely due to deliberate practice. Future research should aim to understand how spiritual voice-hearers cultivate and control voice-hearing after its onset, which may inform interventions for people with distressing voices.

From the Discussion

As has been reported in previous studies, the ability to exhibit control over or influence voices seems to be an important difference between experiences reported by clinical and non-clinical groups.  A key distinction here is between volitional control (ability to bring on or stop voices intentionally), and the ability to influence voices (through other strategies such as engagement or distraction from voices), referred to elsewhere as direct and in direct control.  In the present study, the spiritual group reported substantially higher levels of control and influence over voices, compared to patients. Importantly, nearly three-quarters of the group reported a change in their ability to influence the voices over time –compared to 12.5% of psychosis patients–suggesting that this ability is not always present from the onset of voice-hearing in non-clinical populations, and instead can be actively developed. Indeed, our analysis indicated that 88.5% of the spiritual group described their voices starting spontaneously, with 69.2% reporting that this was before they had contact with spiritualism itself. Thus, while most of the group (96.2%) reported ongoing cultivation of the voices, and often reported developing influence over time, it seems that spiritual practices mostly do not elicit the actual initial onset of the voices, instead playing a role in honing the experience. 

Tuesday, December 14, 2021

Not so much rational but rationalizing: Humans evolved as coherence-seeking, fiction-making animals

Yong, J. C., Li, N. P., & Kanazawa, S. 
(2021). American Psychologist, 76(5), 781–793. 
https://doi.org/10.1037/amp0000674

Abstract

The evidence for biased perceptions and judgments in humans coupled with evidence for ecological rationality in nonhuman animals suggest that the claim that humans are the rational animal may be overstated. We instead propose that discussions of human psychology may benefit from viewing ourselves not so much as rational animals but rather as the rationalizing animal. The current article provides evidence that rationalization is unique to humans and argues that rationalization processes (e.g., cognitive dissonance reduction, post hoc justification of choices, confabulation of reasons for moral positions) are aimed at creating the fictions we prefer to believe and maintaining the impression that we are psychologically coherent and rational. Coherence appears to be prioritized at the expense of veridicality, suggesting that distorted perceptions and appraisals can be adaptive for humans—under certain circumstances, we are better off understanding ourselves and reality not so accurately. Rationalization also underlies the various shared beliefs, religions, norms, and ideologies that have enabled humans to organize and coordinate their actions on a grand scale, for better or worse. We conclude with a discussion of the implications of this unique human psychological trait.

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Adaptive Benefit 6: Deceiving Others

While the act of rationalization can be fundamentally regarded as a self-deception perpetuated by humans to maintain a rational or positive self-view, rationalization processes can also be utilized to distort perceptions of reality to strategically misinform others. Other-deception is a strategy that has evolved in our ancestors’ struggle to accrue resources, and people frequently lie to those on whom they are dependent to receive resources that might otherwise not be provided (Steinel & De Dreu, 2004). Rationalization facilitates deception by making a lie the focal, preferred belief, after which reality is reinterpreted to make the lie appear more plausible. For instance, a person may steal from his friend and then lie about how he was out of town during the theft. Thereafter, beliefs about the self and information pertaining to the theft, such as details about his travels or other potential suspects, may be reconstructed in his own mind to maintain the ruse. Individuals who cheat on their partners can rationalize their actions to such an extent that they become convinced of their lack of responsibility in the affair (Foster & Misra, 2013).

As being caught as a deceiver is costly through either immediate retaliation (e.g., withdrawal of cooperation) or incurring an untrustworthy reputation (Brosnan & Bshary, 2010), people who desire to misinform can increase their effectiveness by being unaware of the misinformation themselves. Cues that give away deceptive intent include signs of nervousness, suppression, and cognitive load (von Hippel & Trivers, 2011). By believing their lies or excuses to be actually true, deceivers can sell their fictions while obscuring the cues associated with consciously mediated deception. Furthermore, attribution of intent is critical in determining whether the deceived seeks retribution or forgives (Schweitzer et al., 2006). By maintaining that there was no intent to deceive, unaware deceivers are more likely than conscious deceivers to avoid retribution.

Monday, December 13, 2021

Toward an understanding of structural racism: Implications for criminal justice

Julian M. Rucker and Jennifer A. Richeson
Science, 374 (6565)
DOI: 10.1126/science.abj7779

Abstract

Racial inequality is a foundational feature of the criminal justice system in the United States. Here we offer a psychological account for how Americans have come to tolerate a system that is so at odds with their professed egalitarian values. We argue that beliefs about the nature of racism—as being solely due to prejudiced individuals rather than structural factors that disadvantage marginalized racial groups—work to uphold racial stratification in the criminal justice system. Although acknowledging structural racism facilitates the perception of and willingness to reduce racial inequality in criminal justice outcomes, many Americans appear willfully ignorant of structural racism in society. We reflect on the role of psychological science in shaping popular understandings of racism and discuss how to contribute more meaningfully to its reduction.

From the Summary and self-reflection

In this Review, we sought to illustrate key social-psychological factors that shape the maintenance and justification of a racially unjust criminal justice system, despite large scale support for racially egalitarian values.  Psychological motives to substantiate the racial hierarchy and protect one’s self-image work against opportunities to increase exposure to critical education on the structural underpinnings of contemporary racial inequality.  In essence, ignorance and denial of structural racism protect against an indictment of the legitimacy of the criminal justice system. By contrast, acknowledgment of structural racism in society motivates efforts to reduce racially disparate outcomes. With this framework, it becomes clear that merely holding egalitarian attitudes is insufficient to reform and dismantle systems that reproduce racial inequality—a structural understanding of racism is integral to these objectives.

Sunday, December 12, 2021

Moral Psychopharmacology Needs Moral Inquiry: The Case of Psychedelics

Langlitz N, et al. (2021) 
Front. Psychiatry, August, 12:680064

Abstract

The revival of psychedelic research coincided and more recently conjoined with psychopharmacological research on how drugs affect moral judgments and behaviors. This article makes the case for a moral psychopharmacology of psychedelics that examines whether psychedelics serve as non-specific amplifiers that enable subjects to (re-)connect with their values, or whether they promote specific moral-political orientations such as liberal and anti-authoritarian views, as recent psychopharmacological studies suggest. This question gains urgency from the fact that the return of psychedelics from counterculture and underground laboratories to mainstream science and society has been accompanied by a diversification of their users and uses. We propose bringing the pharmacological and neuroscientific literature into a conversation with historical and anthropological scholarship documenting the full spectrum of moral and political views associated with the uses of psychedelics. This paper sheds new light on the cultural plasticity of drug action and has implications for the design of psychedelic pharmacopsychotherapies. It also raises the question of whether other classes of psychoactive drugs have an equally rich moral and political life.

From the Conclusion

If moral psychopharmacology took it upon itself to develop forms of psychedelic apprenticeship for the currently sprawling medical and non-medical applications of psychedelics, it would extend pharmaceutical research and development into the extra-pharmacological realm. Such a design process needs to be informed by best practices in clinical psychology and cognate fields, but, intellectually, it cannot hide behind professional prescriptions because what counts as good and bad is precisely what is at stake here. It is an open philosophical question that has to be answered in a recursive process of psychopharmacological experimentation, clinical and ethnographic observation, historical research, and ethical reflection.

Saturday, December 11, 2021

Older adults across the globe exhibit increased prosocial behavior but also greater in-group preferences

Cutler, J., Nitschke, J.P., Lamm, C. et al. 
Nat Aging 1, 880–888 (2021).
https://doi.org/10.1038/s43587-021-00118-3

Abstract

Population aging is a global phenomenon with substantial implications across society. Prosocial behaviors—actions that benefit others—promote mental and physical health across the lifespan and can save lives during the COVID-19 pandemic. We examined whether age predicts prosociality in a preregistered global study (46,576 people aged 18–99 across 67 countries) using two acutely relevant measures: distancing during COVID-19 and willingness to donate to hypothetical charities. Age positively predicted prosociality on both measures, with increased distancing and donations among older adults. However, older adults were more in-group focused than younger adults in choosing who to help, making larger donations to national over international charities and reporting increased in-group preferences. In-group preferences helped explain greater national over international donations. Results were robust to several control analyses and internal replication. Our findings have vital implications for predicting the social and economic impacts of aging populations, increasing compliance with public health measures and encouraging charitable donations.

Main

Prosocial behaviors have critical individual and societal impacts. Emerging evidence suggests that older adults might be more prosocial than younger adults on measures including economic games learning about rewards for others, effortful actions and charitable donations. In line with this, theoretical accounts of lifespan development, such as socioemotional selectivity theory, propose that motivation for socially and emotionally meaningful behaviors increases as a result of age-related differences in goals and priorities. However, most research has tested participants from western, educated, industrialized, rich and democratic populations. It is unknown whether increased prosociality is shown by older adults across the world. Moreover, although some studies point to increased prosocial behavior, others find no association or even heightened negative behaviors, including greater bias toward one’s own emotions, increased stereotyping of outgroups and less support for foreign aid. Together these findings suggest that age might be associated with both increased positive helping behaviors but also heightened self-serving and in-group preferences.

Friday, December 10, 2021

How social relationships shape moral wrongness judgments

Earp, B.D., McLoughlin, K.L., Monrad, J.T. et al. 
Nat Commun 12, 5776 (2021).

Abstract

Judgments of whether an action is morally wrong depend on who is involved and the nature of their relationship. But how, when, and why social relationships shape moral judgments is not well understood. We provide evidence to address these questions, measuring cooperative expectations and moral wrongness judgments in the context of common social relationships such as romantic partners, housemates, and siblings. In a pre-registered study of 423 U.S. participants nationally representative for age, race, and gender, we show that people normatively expect different relationships to serve cooperative functions of care, hierarchy, reciprocity, and mating to varying degrees. In a second pre-registered study of 1,320 U.S. participants, these relationship-specific cooperative expectations (i.e., relational norms) enable highly precise out-of-sample predictions about the perceived moral wrongness of actions in the context of particular relationships. In this work, we show that this ‘relational norms’ model better predicts patterns of moral wrongness judgments across relationships than alternative models based on genetic relatedness, social closeness, or interdependence, demonstrating how the perceived morality of actions depends not only on the actions themselves, but also on the relational context in which those actions occur.

From the General Discussion

From a theoretical perspective, one aspect of our current account that requires further attention is the reciprocity function. In contrast with the other three functions considered, relationship-specific prescriptions for reciprocity did not significantly predict moral judgments for reciprocity violations. Why might this be so? One possibility is that the model we tested did not distinguish between two different types of reciprocity. In some relationships, such as those between strangers, acquaintances, or individuals doing business with one another, each party tracks the specific benefits contributed to, and received from, the other. In these relationships, reciprocity thus takes a tit-for-tat form in which benefits are offered and accepted on a highly contingent basis. This type of reciprocity is transactional, in that resources are provided, not in response to a real or perceived need on the part of the other, but rather, in response to the past or expected future provision of a similarly valued resource from the cooperation partner. In this, it relies on an explicit accounting of who owes what to whom, and is thus characteristic of so-called “exchange” relationships.

In other relationships, by contrast, such as those between friends, family members, or romantic partners – so-called “communal” relationships – reciprocity takes a different form: that of mutually expected responsiveness to one another’s needs. In this form of reciprocity, each party tracks the other’s needs (rather than specific benefits provided) and strives to meet these needs to the best of their respective abilities, in proportion to the degree of responsibility each has assumed for the other’s welfare. Future work on moral judgments in relational context should distinguish between these two types of reciprocity: that is, mutual care-based reciprocity in communal relationships (when both partners have similar needs and abilities) and tit-for-tat reciprocity between “transactional” cooperation partners who have equal standing or claim on a resource.