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

Sunday, November 6, 2022

‘Breakthrough’ finding shows how modern humans grow more brain cells than Neanderthals

Rodrigo Pérez Ortega
Science.org
Originally posted 8 SEP 22

We humans are proud of our big brains, which are responsible for our ability to plan ahead, communicate, and create. Inside our skulls, we pack, on average, 86 billion neurons—up to three times more than those of our primate cousins. For years, researchers have tried to figure out how we manage to develop so many brain cells. Now, they’ve come a step closer: A new study shows a single amino acid change in a metabolic gene helps our brains develop more neurons than other mammals—and more than our extinct cousins, the Neanderthals.

The finding “is really a breakthrough,” says Brigitte Malgrange, a developmental neurobiologist at the University of Liège who was not involved in the study. “A single amino acid change is really, really important and gives rise to incredible consequences regarding the brain.”

What makes our brain human has been the interest of neurobiologist Wieland Huttner at the Max Planck Institute of Molecular Cell Biology and Genetics for years. In 2016, his team found that a mutation in the ARHGAP11B gene, found in humans, Neanderthals, and Denisovans but not other primates, caused more production of cells that develop into neurons. Although our brains are roughly the same size as those of Neanderthals, our brain shapes differ and we created complex technologies they never developed. So, Huttner and his team set out to find genetic differences between Neanderthals and modern humans, especially in cells that give rise to neurons of the neocortex. This region behind the forehead is the largest and most recently evolved part of our brain, where major cognitive processes happen.

The team focused on TKTL1, a gene that in modern humans has a single amino acid change—from lysine to arginine—from the version in Neanderthals and other mammals. By analyzing previously published data, researchers found that TKTL1 was mainly expressed in progenitor cells called basal radial glia, which give rise to most of the cortical neurons during development.

Saturday, November 5, 2022

A guide to establishing ethics committees in behavioral health settings

Cox D. J. (2020). 
Behavior analysis in practice, 13(4), 939–949.
https://doi.org/10.1007/s40617-020-00455-6

Abstract

Ethical statements typically involve rules. All rules can vary in accuracy and specificity depending on the context to which they are applied. Codes of ethics often involve ethical rules that are written generally to cover the wide-ranging set of possible situations any one member of the profession may encounter. But, despite being written generally, codes of ethics are applied to specific situations that professional members encounter. The application of general rules to specific contexts can sometimes be challenging and complex. Healthcare organizations have several options to help their employees behave ethically. One approach is to appoint a single ethics coordinator (Brodhead & Higbee, 2012). In contrast, the dominant approach in most healthcare organizations is to develop an organizational ethics committee (Moon, 2009). Despite the popularity of the ethics committee in other professions, it is unknown the extent to which organizations that provide ABA services have established and operate ethics committees. Ethics coordinator roles and ethics committees each have benefits and drawbacks. This article reviews the benefits and drawbacks of appointing an ethics coordinator and establishing an ethics committee. And, for interested organizations, this article outlines the steps and considerations that organizations can use to guide the creation of an ethics committee.

Conclusion 

Codes of ethics that guide helping professionals have to be written generally to cover the wide-ranging set of possible situations any one member of the profession may encounter. Despite being written generally, ethical guidelines are applied to specific situations that professional members encounter. The application of general rules to specific contexts can sometimes be challenging and complex (e.g., Bailey & Burch, 2011; Sush & Najdowski, 2019). Healthcare organizations can take several strategies to help their employees behave ethically. One approach is to appoint a single ethics coordinator (Brodhead & Higbee, 2012). In contrast, the dominant approach in most healthcare organizations is to develop an organizational ethics committee (Moon, 2019). Despite the popularity of the ethics committee in other professions, it is unknown the extent to which organizations that provide ABA services have established and operate ethics committees. For organizations interested in establishing an ethics committee, this article provided an overview of the steps that should likely be considered.

Friday, November 4, 2022

Mental Health Implications of Abortion Restrictions for Historically Marginalized Populations

Ogbu-Nwobodo, L., Shim, R.S., et al.
October 27, 2022
N Engl J Med 2022; 387:1613-1617
DOI: 10.1056/NEJMms2211124

Here is an excerpt:

Abortion and Mental Health

To begin with, abortion does not lead to mental health harm — a fact that has been established by data and recognized by the National Academies of Sciences, Engineering, and Medicine and the American Psychological Association The Turnaway Study, a longitudinal study that compared mental health outcomes among people who obtained an abortion with those among people denied abortion care, found that abortion denial was associated with initially higher levels of stress, anxiety, and low self-esteem than was obtaining of wanted abortion care. People who had an abortion did not have an increased risk of any mental health disorder, including depression, anxiety, suicidal ideation, post-traumatic stress disorder, or substance use disorders. Whether people obtained or were denied an abortion, those at greatest risk for adverse psychological outcomes after seeking an abortion were those with a history of mental health conditions or of child abuse or neglect and those who perceived abortion stigma (i.e., they felt others would look down on them for seeking an abortion). Furthermore, people who are highly oppressed and marginalized by society are more vulnerable to psychological distress.

There is evidence that people seeking abortion have poorer baseline mental health, on average, than people who are not seeking an abortion. However, this poorer mental health results in part from structural inequities that disproportionately expose some populations to poverty, trauma, adverse childhood experiences (including physical and sexual abuse), and intimate partner violence. People seek abortion for many reasons, including (but not limited to) timing issues, the need to focus on their other children, concern for their own physical or mental health, the desire to avoid exposing a child to a violent or abusive partner, and the lack of financial security to raise a child.

In addition, for people with a history of mental illness, pregnancy and the postpartum period are a time of high risk, with increased rates of recurrence of psychiatric symptoms and of adverse pregnancy and birth outcomes. Because of stigma and discrimination, birthing or pregnant people with serious mental illnesses or substance use disorders are more likely to be counseled by health professionals to avoid or terminate pregnancies, as highlighted by a small study of women with bipolar disorder. One study found that among women with mental health conditions, the rate of readmission to a psychiatric hospital was not elevated around the time of abortion, but there was an increased rate of hospitalization in psychiatric facilities at the time of childbirth. Data also indicate that for people with preexisting mental health conditions, mental health outcomes are poor whether they obtain an abortion or give birth.

The Role of Structural Racism

Structural racism — defined as ongoing interactions between macro-level systems and institutions that constrain the resources, opportunities, and power of marginalized racial and ethnic groups — is widely considered a fundamental cause of poor health and racial inequities, including adverse maternal health outcomes. Structural racism ensures the inequitable distribution of a broad range of health-promoting resources and opportunities that unfairly advantage White people and unfairly disadvantage historically marginalized racial and ethnic groups (e.g., education, paid leave from work, access to high-quality health care, safe neighborhoods, and affordable housing). In addition, structural racism is responsible for inequities and poor mental health outcomes among many diverse populations.


Thursday, November 3, 2022

What Makes a Great Life?

Jon Clifton
Gallup.com
Originally posted 22 SEPT 22

While many things contribute to a great life, Gallup finds five aspects that all people have in common: their work, finances, physical health, communities, and relationships with family and friends. If you are excelling in each of these elements of wellbeing, you are highly likely to be thriving in life.

(cut)

Gallup's research as well as research by the global community of wellbeing practitioners has produced hundreds, if not thousands, of discoveries.

One of the most famous discoveries is the U-curve of happiness, which shows how age is associated with wellbeing. Young people rate their lives high, and so do older people. But middle-aged people rate their lives the lowest. This trend holds every year in almost every country in the world. It is nicknamed the "U-curve" of happiness because when you look at the graph, it looks like a "U." Some jokingly say that the chart is smiling.

Some discoveries are astonishing; others feel like they reveal a "blandly sophomoric secret," as George Gallup referred to some of his longevity findings. For example, you could argue that the U-curve of happiness simply quantifies conventional wisdom -- that people have midlife crises.

Here are a few of the discoveries that are truly compelling:
  • People who love their jobs do not hate Mondays.
  • Education-related debt can cause an emotional scar that remains even after you pay off the debt.
  • Volunteering is not just good for the people you are helping; it is also good for you.
  • Exercising is better at eliminating fatigue than prescription drugs.
  • Loneliness can double your risk of dying from heart disease.
We could list every insight ever produced from this research and encourage leaders to work on all of them. Instead, we took another approach. Using all these insights from across the industry combined with our surveys and analysis, we created the five elements of wellbeing. And our ongoing global research confirms that the five elements of wellbeing are significant drivers of a great life everywhere.

Wednesday, November 2, 2022

How the Classics Changed Research Ethics

Scott Sleek
Psychological Science
Originally posted 31 AUG 22

Here is an excerpt:

Social scientists have long contended that the Common Rule was largely designed to protect participants in biomedical experiments—where scientists face the risk of inducing physical harm on subjects—but fits poorly with the other disciplines that fall within its reach.

“It’s not like the IRBs are trying to hinder research. It’s just that regulations continue to be written in the medical model without any specificity for social science research,” she explained. 

The Common Rule was updated in 2018 to ease the level of institutional review for low-risk research techniques (e.g., surveys, educational tests, interviews) that are frequent tools in social and behavioral studies. A special committee of the National Research Council (NRC), chaired by APS Past President Susan Fiske, recommended many of those modifications. Fisher was involved in the NRC committee, along with APS Fellows Richard Nisbett (University of Michigan) and Felice J. Levine (American Educational Research Association), and clinical psychologist Melissa Abraham of Harvard University. But the Common Rule reforms have yet to fully expedite much of the research, partly because the review boards remain confused about exempt categories, Fisher said.  

Interference or support? 

That regulatory confusion has generated sour sentiments toward IRBs. For decades, many social and behavioral scientists have complained that IRBs effectively impede scientific progress through arbitrary questions and objections. 

In a Perspectives on Psychological Science paper they co-authored, APS Fellows Stephen Ceci of Cornell University and Maggie Bruck of Johns Hopkins University discussed an IRB rejection of their plans for a study with 6- to 10-year-old participants. Ceci and Bruck planned to show the children videos depicting a fictional police officer engaging in suggestive questioning of a child.  

“The IRB refused to approve the proposal because it was deemed unethical to show children public servants in a negative light,” they wrote, adding that the IRB held firm on its rejection despite government funders already having approved the study protocol (Ceci & Bruck, 2009). 

Other scientists have complained the IRBs exceed their Common Rule authority by requiring review of studies that are not government funded. In 2011, psychological scientist Jin Li sued Brown University in federal court for barring her from using data she collected in a privately funded study on educational testing. Brown’s IRB objected to the fact that she paid her participants different amounts of compensation based on need. (A year later, the university settled the case with Li.) 

In addition, IRBs often hover over minor aspects of a study that have no genuine relation to participant welfare, Ceci said in an email interview.  

Tuesday, November 1, 2022

LinkedIn ran undisclosed social experiments on 20 million users for years to study job success

Kathleen Wong
USAToday.com
Originally posted 25 SEPT 22

A new study analyzing the data of over 20 million LinkedIn users over the timespan of five years reveals that our acquaintances may be more helpful in finding a new job than close friends.

Researchers behind the study say the findings will improve job mobility on the platform, but since users were unaware of their data being studied, some may find the lack of transparency concerning.  

Published this month in Science, the study was conducted by researchers from LinkedIn, Harvard Business School and the Massachusetts Institute of Technology between 2015 and 2019. Researchers ran "multiple large-scale randomized experiments" on the platform's "People You May Know" algorithm, which suggests new connections to users. 

In a practice known as A/B testing, the experiments included giving certain users an algorithm that offered different (like close or not-so-close) contact recommendations and then analyzing the new jobs that came out of those two billion new connections.

(cut)

A question of ethics

Privacy advocates told the New York Times Sunday that some of the 20 million LinkedIn users may not be happy  that their data was used without consent. That resistance is part of a longstanding  pattern of people's data being tracked and used by tech companies without their knowledge.

LinkedIn told the paper it "acted consistently" with its user agreement, privacy policy and member settings.

LinkedIn did not respond to an email sent by USA TODAY on Sunday. 

The paper reports that LinkedIn's privacy policy does state the company reserves the right to use its users' personal data.

That access can be used "to conduct research and development for our Services in order to provide you and others with a better, more intuitive and personalized experience, drive membership growth and engagement on our Services, and help connect professionals to each other and to economic opportunity." 

It can also be deployed to research trends.

The company also said it used "noninvasive" techniques for the study's research. 

Aral told USA TODAY that researchers "received no private or personally identifying data during the study and only made aggregate data available for replication purposes to ensure further privacy safeguards."

Monday, October 31, 2022

Longest Strike Ends: California Mental Health Care Workers Win Big

Cal Wilslow
Counterpunch.org
Originally posted 24 OCT 22

Two thousand mental health clinicians have won; Kaiser Permanente has lost. The 10- week strike has ended in near total victory for the National Union of Healthcare Workers (NUHW). The therapists, walked out on August 15; it became the longest mental health care workers’ strike recorded.

Two issues dominated negotiations from the start: workload for Kaiser therapists and wait time for Kaiser patients. The strikers won on both, forcing concessions until now all but unheard of. The strikers won break through provisions to retain staff, reduce wait times for patients and a plan to collaborate on transforming Kaiser’s model for providing mental health care. The new four-year contract is retroactive to September 2021 and expires in September 2025. Darrell Steinberg, Mayor of Sacramento served as a mediator. Members of the NUHW voted 1561 to 36 to ratify it.

Braving three- digit heat, strikers walked picket lines throughout Northern California and the Central Valley. They picketed, marched and rallied at Kaiser hospitals – in a strike that caught the attention of mental health care advocates everywhere. “Our strike was difficult and draining, but it was worth it,” said Natalie Rogers, a therapist for Kaiser in Santa Rosa. We stood up to the biggest nonprofit in the nation, and we made gains that will help better serve our patients and will advance the cause of mental health parity throughout the country.”

The mental health clinicians I’ve met are almost universally modest and careful in their choice of words, and here is an example. To say that that Kaiser is “the biggest non-profit” is an understatement to say the least – its revenues are in the billions, and its managers make millions while this giant among giants, typically in the world of corporate health care, oversees its empire as if it were making cars and trucks.

I’ve seen NUHW rallies well-attended by patients themselves, also family members and supporters who are angry, bitter. Where frequently they carry signs to the effect that the issues here are life and death, rallies where speakers break down in tears, where placards tell us that suicide can be the outcome of care denied – “Stop the Suicides!” It’s a wonder more therapists don’t move on. The world of pain of the mental health patient can be just as acute as that of the medical patient. Ask a therapist. It’s not that the clinicians don’t want to tell us this.; it’s that, in their own way, they are telling us. It’s why they fight so hard.

Sunday, October 30, 2022

The uselessness of AI ethics

Munn, L. The uselessness of AI ethics.
AI Ethics (2022).

Abstract

As the awareness of AI’s power and danger has risen, the dominant response has been a turn to ethical principles. A flood of AI guidelines and codes of ethics have been released in both the public and private sector in the last several years. However, these are meaningless principles which are contested or incoherent, making them difficult to apply; they are isolated principles situated in an industry and education system which largely ignores ethics; and they are toothless principles which lack consequences and adhere to corporate agendas. For these reasons, I argue that AI ethical principles are useless, failing to mitigate the racial, social, and environmental damages of AI technologies in any meaningful sense. The result is a gap between high-minded principles and technological practice. Even when this gap is acknowledged and principles seek to be “operationalized,” the translation from complex social concepts to technical rulesets is non-trivial. In a zero-sum world, the dominant turn to AI principles is not just fruitless but a dangerous distraction, diverting immense financial and human resources away from potentially more effective activity. I conclude by highlighting alternative approaches to AI justice that go beyond ethical principles: thinking more broadly about systems of oppression and more narrowly about accuracy and auditing.

(cut)

Meaningless principles

The deluge of AI codes of ethics, frameworks, and guidelines in recent years has produced a corresponding raft of principles. Indeed, there are now regular meta-surveys which attempt to collate and summarize these principles. However, these principles are highly abstract and ambiguous, becoming incoherent. Mittelstadt suggests that work on AI ethics has largely produced “vague, high-level principles, and value statements which promise to be action-guiding, but in practice provide few specific recommendations and fail to address fundamental normative and political tensions embedded in key concepts.” The point here is not to debate the merits of any one value over another, but to highlight the fundamental lack of consensus around key terms. Commendable values like “fairness” and “privacy” break down when subjected to scrutiny, leading to disparate visions and deeply incompatible goals.

What are some common AI principles? Despite the mushrooming of ethical statements, Floridi and Cowls suggest many values recur frequently and can be condensed into five core principles: beneficence, non-maleficence, autonomy, justice, and explicability. These ideals sound wonderful. After all, who could be against beneficence? However, problems immediately arise when we start to define what beneficence means. In the Montreal principles for instance, “well-being” is the term used, suggesting that AI development should promote the “well-being of all sentient creatures.” While laudable, clearly there are tensions to consider here. We might think, for instance, of how information technologies support certain conceptions of human flourishing by enabling communication and business transactions—while simultaneously contributing to carbon emissions, environmental degradation, and the climate crisis. In other words, AI promotes the well-being of some creatures (humans) while actively undermining the well-being of others.

The same issue occurs with the Statement on Artificial Intelligence, Robotics, and Autonomous Systems. In this Statement, beneficence is gestured to through the concept of “sustainability,” asserting that AI must promote the basic preconditions for life on the planet. Few would argue directly against such a commendable aim. However, there are clearly wildly divergent views on how this goal should be achieved. Proponents of neoliberal interventions (free trade, globalization, deregulation) would argue that these interventions contribute to economic prosperity and in that sense sustain life on the planet. In fact, even the oil and gas industry champions the use of AI under the auspices of promoting sustainability. Sustainability, then, is a highly ambiguous or even intellectually empty term that is wrapped around disparate activities and ideologies. In a sense, sustainability can mean whatever you need it to mean. Indeed, even one of the members of the European group denounced the guidelines as “lukewarm” and “deliberately vague,” stating they “glossed over difficult problems” like explainability with rhetoric.