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, February 23, 2023

Moral foundations partially explain the association of the Dark Triad traits with homophobia and transphobia

Kay, C. S., & Dimakis, S. M. (2022, June 24). 
https://doi.org/10.31234/osf.io/pukds

Abstract

People with antagonistic personality traits are reportedly more racist, sexist, and xenophobic than their non-antagonistic counterparts. In the present studies (N1 = 718; N2 = 267), we examined whether people with antagonistic personality traits are also more likely to hold homophobic and transphobic attitudes, and, if they are, whether this can be explained by their moral intuitions. We found that people high in Machiavellianism, narcissism, and psychopathy are more likely to endorse homophobic and transphobic views. The associations of Machiavellianism and psychopathy with homophobia and transphobia were primarily explained by low endorsement of individualizing moral foundations (i.e., care and fairness), while the association of narcissism with these beliefs was primarily explained by high endorsement of the binding moral foundations (i.e., loyalty, authority, and sanctity). These findings provide insight into the types of people who harbour homophobic and transphobic attitudes and how differences in moral dispositions contribute to their LGBTQ+ prejudice.

General discussion

We conducted two studies to test whether those with antagonistic personality traits (e.g., Machiavellianism, grandiose narcissism, and psychopathy) are more likely to express homonegative and transphobic views, and, if so, whether this is because of their moral intuitions.Study 1 used a convenience sample of 718undergraduate students drawn from a university Human Subjects Pool. It was exploratory, in the sense that we specified no formal hypotheses. That said, we suspected that those with antagonistic personality traits would be more likely to hold homonegative and transphobic attitudes and that they may do so because they dismiss individualizing morals concerns (e.g., do no harm; treat others fairly). At the same time, we suspected that those with antagonistic personality traits would also deemphasize the binding moral foundations (e.g., be loyal to your ingroup; respect authority; avoid contaminants, even those that are metaphysical),weakening any observed associations between the antagonistic personality traits and LGBTQ+ prejudice. The purpose of Study 2 was to examine whether the findings identified in Study 1 would generalize beyond a sample of undergraduate students.  Since we had no reason to suspect the results would differ between Study 1 and Study 2, our preregistered hypotheses for Study 2 were that we would observe the same pattern of results identified in Study 1.

There was clear evidence across both studies that those high in the three antagonistic personality traits were more likely to endorse statements that were reflective of traditional homonegativity, modern homonegativity, general genderism/transphobia, and gender-bashing. All of these associations were moderate-to-large in magnitude (Funder & Ozer, 2019), save for the association between narcissism and traditional homonegativity in Study 1. These results indicate that, on top of harbouring racist(Jones, 2013), xenophobic (Hodson et al., 2009), and sexist (Gluck et al., 2020) attitudes, those high in antagonistic personality traits also harbour homonegative and transphobic attitudes.

Wednesday, February 22, 2023

How and Why People Want to Be More Moral

Sun, J., Wilt, J. A., et al. (2022, October 13).
https://doi.org/10.31234/osf.io/6smzh

Abstract

What types of moral improvements do people wish to make? Do they hope to become more good, or less bad? Do they wish to be more caring? More honest? More loyal? And why exactly do they want to become more moral? Presumably, most people want to improve their morality because this would benefit others, but is this in fact their primary motivation? Here, we begin to investigate these questions. Across two large, preregistered studies (N = 1,818), participants provided open-ended descriptions of one change they could make in order to become more moral; they then reported their beliefs about and motives for this change. In both studies, people most frequently expressed desires to improve their compassion and more often framed their moral improvement goals in terms of amplifying good behaviors than curbing bad ones. The strongest predictor of moral motivation was the extent to which people believed that making the change would have positive consequences for their own well-being. Together, these studies provide rich descriptive insights into how ordinary people want to be more moral, and show that they are particularly motivated to do so for their own sake.

From the General Discussion section

Self-Interest is a KeyMotivation for Moral Improvement

What motivates people to be more moral? From the perspective that the function of morality is to suppress selfishness for the benefit of others (Haidt & Kesebir, 2010; Wolf, 1982), we might expect people to believe that moral improvements would primarily benefit others (rather than themselves). By a similar logic, people should also primarily want to be more moral for the sake of others (rather than for their own sake).

Surprisingly, however, this was not overwhelmingly the case. Instead, across both studies, participants were approximately equally split between those who believed that others would benefit the most and those who believed that they themselves would benefit the most(with the exception of compassion; see Figure S2). The finding that people perceive some personal benefits to becoming more moral has been demonstrated in recent research (Sun & Berman, in prep). In light of evidence that moral people tend to be happier (Sun et al., in prep) and that the presence of moral struggles predicts symptoms of depression and anxiety (Exline et al., 2014), such beliefs might also be somewhat accurate.  However, it is unclear why people believe that becoming more moral would benefit themselves more than it would others. Speculatively, one possibility is that people can more vividly imagine the impacts of their own actions on their own well-being, whereas they are much more uncertain about how their actions would affect others—especially when the impacts might be spread across many beneficiaries.

However, it is also possible that this finding only applies to self-selected moral improvements, rather than the universe of all possible moral improvements. That is, when asked what they could do to become more moral, people might more readily think of improvements that would improve their own well-being to a greater extent than the well-being of others. But, if we were to ask people to predict who would benefit the most from various moral improvements that were selected by researchers, people may be less likely to believe that it would be themselves. Future research should systematically study people’s evaluations of how various moral improvements would impact their own and others’ well-being.

Similarly, when explicitly asked for whose sake they were most motivated to make their moral improvement, almost half of the participants admitted that they were most motivated to change for their own sake (rather than for the sake of others).  However, when predicting motivation from both the expected well-being consequences for the self and the well-being consequences for others, we found that people’s perceptions of personal well-being consequences was a significantly stronger predictor in both studies.  In other words, if anything, people are relatively more motivated to make moral improvements for their own sake than for the sake of others.  This is consistent with the findings of another study which examined people’s interest in changing a variety of moral and nonmoral traits, and showed that people are particularly interested in improving the traits that they believed would make them relatively happier (Sun & Berman, in prep). Here, it is striking that personal fulfilment remains the most important motivator of personal improvement even exclusively in the moral domain.

Tuesday, February 21, 2023

Motornomativity: How Social Norms Hide a Major Public Health Hazard

Walker, I., Tapp, A., & Davis, A.
(2022, December 14).
https://doi.org/10.31234/osf.io/egnmj

Abstract

Decisions about motor transport, by individuals and policy-makers, show unconscious biases due to cultural assumptions about the role of private cars - a phenomenon we term motonormativity. To explore this claim, a national sample of 2157 UK adults rated, at random, a set of statements about driving (“People shouldn't drive in highly populated areas where other people have to breathe in the car fumes”) or a parallel set of statements with key words changed to shift context ("People shouldn't smoke in highly populated areas where other people have to breathe in the cigarette fumes"). Such context changes could radically alter responses (75% agreed with "People shouldn't smoke... " but only 17% agreed with "People shouldn't drive... "). We discuss how these biases systematically distort medical and policy decisions and give recommendations for how public policy and health professionals might begin to recognise and address these unconscious biases in their work.

Discussion

Our survey showed that people can go from agreeing with a health or risk-related proposition to disagreeing with it simply depending on whether it is couched as a driving or non-driving issue. In the most dramatic case, survey respondents felt that obliging people to breathe toxic fumes went from being unacceptable to acceptable depending on whether the fumes came from cigarettes or motor vehicles. It is, objectively, nonsensical that the ethical and public health issues involved in forcing non-consenting people to inhale air-borne toxins should be judged differently depending on their source, but that is what happened here. It seems that normal judgement criteria can indeed be suspended in the specific context of motoring, as we suggested.

Obviously, we used questions in this study that we felt would stand a good chance of demonstrating a difference between how motoring and non-motoring issues were viewed. But choosing questions likely to reveal differences is not the same thing as stacking the deck. We gave the social bias every chance to reveal itself, but that could only happen because it was out there to be revealed. Prentice and Miller (1992) argue that the ease with which a behavioural phenomenon can be triggered is an index of its true magnitude. The ease with which effects appeared in this study was striking: in the final question the UK public went from 17% agreement to 75% agreement just by changing two words in the question whilst leaving its underlying principle unchanged.


Another example of a culturally acceptable (or ingrained) bias for harm. Call it "car blindness" or "motornormativity."

Monday, February 20, 2023

Definition drives design: Disability models and mechanisms of bias in AI technologies

Newman-Griffis, D., et al. (2023).
First Monday, 28(1).
https://doi.org/10.5210/fm.v28i1.12903

Abstract

The increasing deployment of artificial intelligence (AI) tools to inform decision-making across diverse areas including healthcare, employment, social benefits, and government policy, presents a serious risk for disabled people, who have been shown to face bias in AI implementations. While there has been significant work on analysing and mitigating algorithmic bias, the broader mechanisms of how bias emerges in AI applications are not well understood, hampering efforts to address bias where it begins. In this article, we illustrate how bias in AI-assisted decision-making can arise from a range of specific design decisions, each of which may seem self-contained and non-biasing when considered separately. These design decisions include basic problem formulation, the data chosen for analysis, the use the AI technology is put to, and operational design elements in addition to the core algorithmic design. We draw on three historical models of disability common to different decision-making settings to demonstrate how differences in the definition of disability can lead to highly distinct decisions on each of these aspects of design, leading in turn to AI technologies with a variety of biases and downstream effects. We further show that the potential harms arising from inappropriate definitions of disability in fundamental design stages are further amplified by a lack of transparency and disabled participation throughout the AI design process. Our analysis provides a framework for critically examining AI technologies in decision-making contexts and guiding the development of a design praxis for disability-related AI analytics. We put forth this article to provide key questions to facilitate disability-led design and participatory development to produce more fair and equitable AI technologies in disability-related contexts.

Conclusion

The proliferation of artificial intelligence (AI) technologies as behind the scenes tools to support decision-making processes presents significant risks of harm for disabled people. The unspoken assumptions and unquestioned preconceptions that inform AI technology development can serve as mechanisms of bias, building the base problem formulation that guides a technology on reductive and harmful conceptualisations of disability. As we have shown, even when developing AI technologies to address the same overall goal, different definitions of disability can yield highly distinct analytic technologies that reflect contrasting, frequently incompatible decisions in the information to analyse, what analytic process to use, and what the end product of analysis will be. Here we have presented an initial framework to support critical examination of specific design elements in the formulation of AI technologies for data analytics, as a tool to examine the definitions of disability used in their design and the resulting impacts on the technology. We drew on three important historical models of disability that form common foundations for policy, practice, and personal experience today—the medical, social, and relational models—and two use cases in healthcare and government benefits to illustrate how different ways of conceiving of disability can yield technologies that contrast and conflict with one another, creating distinct risks for harm.

Sunday, February 19, 2023

Organs in exchange for freedom? Bill raises ethical concerns

Steve LeBlanc
Associated Press
Originally published 8 FEB 23

BOSTON (AP) — A proposal to let Massachusetts prisoners donate organs and bone marrow to shave time off their sentence is raising profound ethical and legal questions about putting undue pressure on inmates desperate for freedom.

The bill — which faces a steep climb in the Massachusetts Statehouse — may run afoul of federal law, which bars the sale of human organs or acquiring one for “valuable consideration.”

It also raises questions about whether and how prisons would be able to appropriately care for the health of inmates who go under the knife to give up organs. Critics are calling the idea coercive and dehumanizing even as one of the bill’s sponsors is framing the measure as a response to the over-incarceration of Hispanic and Black people and the need for matching donors in those communities.

“The bill reads like something from a dystopian novel,” said Kevin Ring, president of Families Against Mandatory Minimums, a Washington, D.C.-based criminal justice reform advocacy group. “Promoting organ donation is good. Reducing excessive prison terms is also good. Tying the two together is perverse.”

(cut)

Offering reduced sentences in exchange for organs is not only unethical, but also violates federal law, according to George Annas, director of the Center for Health Law, Ethics & Human Rights at the Boston University School of Public Health. Reducing a prison sentence is the equivalent of a payment, he said.

“You can’t buy an organ. That should end the discussion,” Annas said. “It’s compensation for services. We don’t exploit prisoners enough?”

Democratic state Rep. Carlos Gonzalez, another co-sponsor of the bill, defended the proposal, calling it a voluntary program. He also said he’s open to establishing a policy that would allow inmates to donate organs and bone marrow without the lure of a reduced sentence. There is currently no law against prisoner organ donation in Massachusetts, he said.

“It’s not quid pro quo. We are open to setting policy without incentives,” Gonzalez said, adding that it is “crucial to respect prisoners’ human dignity and agency by respecting their choice to donate bone marrow or an organ.”

Saturday, February 18, 2023

More Physicians Are Experiencing Burnout and Depression

Christine Lehmann
Medscape.com
Originally poste 1 FEB 23

More than half of physicians reported feeling burned out this year and nearly 1 in 4 doctors reported feeling depressed — the highest percentages in 5 years, according to the 'I Cry but No One Cares': Physician Burnout & Depression Report 2023.

"Burnout leaves you feeling like someone you're not," said Amaryllis Sánchez, MD, a board-certified family physician and certified physician coach.

"When someone is burned out, they experience extreme exhaustion in the workplace, depersonalization, and a sense that their best is no longer good enough. Over time, this may spill into the rest of their lives, affecting their relationships as well as their general health and well-being," said Sánchez.

When feelings of burnout continue without effective interventions, they can lead to depression, anxiety, and more, she said.

Burnout can persist for months to even years — nearly two thirds of doctors surveyed said their burnout lasted for at least 13 months, and another 30% said it lasted for more than 2 years.

The majority of doctors attributed their burnout to too many bureaucratic tasks, although more than one third said it was because their co-workers treated them with a lack of respect.

"This disrespect can take many forms from demeaning comments toward physicians in training to the undermining of a physicians' decade-long education and training to instances of rudeness or incivility in the exam room. Unfortunately, medical professionals can be the source of bad behavior and disrespect. They may be burned out too, and doing their best to work in a broken healthcare system during an extremely difficult time," said Sánchez.

Friday, February 17, 2023

Free Will Is Only an Illusion if You Are, Too

Alessandra Buccella and Tomáš Dominik
Scientific American
Originally posted January 16, 2023

Here is an excerpt:

In 2019 neuroscientists Uri Maoz, Liad Mudrik and their colleagues investigated that idea. They presented participants with a choice of two nonprofit organizations to which they could donate $1,000. People could indicate their preferred organization by pressing the left or right button. In some cases, participants knew that their choice mattered because the button would determine which organization would receive the full $1,000. In other cases, people knowingly made meaningless choices because they were told that both organizations would receive $500 regardless of their selection. The results were somewhat surprising. Meaningless choices were preceded by a readiness potential, just as in previous experiments. Meaningful choices were not, however. When we care about a decision and its outcome, our brain appears to behave differently than when a decision is arbitrary.

Even more interesting is the fact that ordinary people’s intuitions about free will and decision-making do not seem consistent with these findings. Some of our colleagues, including Maoz and neuroscientist Jake Gavenas, recently published the results of a large survey, with more than 600 respondents, in which they asked people to rate how “free” various choices made by others seemed. Their ratings suggested that people do not recognize that the brain may handle meaningful choices in a different way from more arbitrary or meaningless ones. People tend, in other words, to imagine all their choices—from which sock to put on first to where to spend a vacation—as equally “free,” even though neuroscience suggests otherwise.

What this tells us is that free will may exist, but it may not operate in the way we intuitively imagine. In the same vein, there is a second intuition that must be addressed to understand studies of volition. When experiments have found that brain activity, such as the readiness potential, precedes the conscious intention to act, some people have jumped to the conclusion that they are “not in charge.” They do not have free will, they reason, because they are somehow subject to their brain activity.

But that assumption misses a broader lesson from neuroscience. “We” are our brain. The combined research makes clear that human beings do have the power to make conscious choices. But that agency and accompanying sense of personal responsibility are not supernatural. They happen in the brain, regardless of whether scientists observe them as clearly as they do a readiness potential.

So there is no “ghost” inside the cerebral machine. But as researchers, we argue that this machinery is so complex, inscrutable and mysterious that popular concepts of “free will” or the “self” remain incredibly useful. They help us think through and imagine—albeit imperfectly—the workings of the mind and brain. As such, they can guide and inspire our investigations in profound ways—provided we continue to question and test these assumptions along the way.


Thursday, February 16, 2023

Telehealth Providers Prepare for the Future

Phoebe Kolbert & Charlotte Engrav
msmagazine.com
Originally posted 9 FEB 23

Here is an excerpt:

Telehealth Abortion Care

The Guttmacher Institute reports that, in 2017, medication abortions accounted for 39 percent of all abortions performed. By 2020, medication abortion usage accounted for 53 percent.

Coplon attributes the rise in telehealth medication abortions to COVID, but the continued use of it, she says, “is due to people’s understanding and acceptance, and also providers being more comfortable with providing pills without having the testing that we prior thought we needed.” 

She would know. Since 2016, Coplon has been part of a coalition of researchers, lawyers and other clinicians looking at telehealth medication abortion and ways to increase access to telehealth services. She now serves as the director of clinical operations at Abortion on Demand. 

In 2018, state policies enacted to support reproductive health were almost triple the number restricting reproductive healthcare. It was the first year in at least two decades where protections outpaced restrictions. 

Restrictions were eased even more when the COVID-19 pandemic made social distancing necessary, and lawmakers loosened restrictions, allowing more healthcare to be practiced online via telehealth. However, the landscape completely changed again in June of this year when the Supreme Court overturned the longstanding precedent of Roe in their Dobbs decision. Now, 18 states have abortion bans, 14 of which are total or near total. Eight other states have abortion bans on the books that are currently blocked, and there has been a push from anti-abortion groups to rescind access to telehealth medication abortions altogether. 

Telemedicine abortion has many benefits beyond preventing the spread of COVID-19—which may be why anti-abortion groups have been so quick to target it. Telehealth can make abortions more accessible for those who want and need them, and they tend to be cheaper and easier to schedule quickly. Even before Roe’s fall, patients would sometimes have to travel out of state or drive hours to the only abortion clinic in their state. Now, people living in states with bans must travel an average of 276 miles each way. States without bans have seen a swell of out-of-state patients seeking legal abortions. Bloomberg News estimated Illinois could face an 8,000 percent increase in abortion seekers. Planned Parenthood of Illinois estimated an increase of 20,000-30,000 out-of-state patients. Some clinics are struggling to keep up. For these clinics and patients, Coplon notes, telehealth can make a huge difference in the post-Roe era.

Not only can telehealth provide appointments within just a day or two of scheduling, as opposed to the potentially weeks-long waits at clinics in some overburdened states, it can also help reduce the overall burden on those in-person clinics—freeing up space for their own clients. 

Wednesday, February 15, 2023

Moralized language predicts hate speech on social media

Kirill Solovev and Nicolas Pröllochs
PNAS Nexus, Volume 2, Issue 1, 
January 2023

Abstract

Hate speech on social media threatens the mental health of its victims and poses severe safety risks to modern societies. Yet, the mechanisms underlying its proliferation, though critical, have remained largely unresolved. In this work, we hypothesize that moralized language predicts the proliferation of hate speech on social media. To test this hypothesis, we collected three datasets consisting of N = 691,234 social media posts and ∼35.5 million corresponding replies from Twitter that have been authored by societal leaders across three domains (politics, news media, and activism). Subsequently, we used textual analysis and machine learning to analyze whether moralized language carried in source tweets is linked to differences in the prevalence of hate speech in the corresponding replies. Across all three datasets, we consistently observed that higher frequencies of moral and moral-emotional words predict a higher likelihood of receiving hate speech. On average, each additional moral word was associated with between 10.76% and 16.48% higher odds of receiving hate speech. Likewise, each additional moral-emotional word increased the odds of receiving hate speech by between 9.35 and 20.63%. Furthermore, moralized language was a robust out-of-sample predictor of hate speech. These results shed new light on the antecedents of hate speech and may help to inform measures to curb its spread on social media.

Significance Statement

This study provides large-scale observational evidence that moralized language fosters the proliferation of hate speech on social media. Specifically, we analyzed three datasets from Twitter covering three domains (politics, news media, and activism) and found that the presence of moralized language in source posts was a robust and meaningful predictor of hate speech in the corresponding replies. These findings offer new insights into the mechanisms underlying the proliferation of hate speech on social media and may help to inform educational applications, counterspeech strategies, and automated methods for hate speech detection.

Discussion

This study provides observational evidence that moralized language in social media posts is associated with more hate speech in the corresponding replies. We uncovered this link for posts from a diverse set of societal leaders across three domains (politics, news media, and activism). On average, each additional moral word was associated with between 10.76 and 16.48% higher odds of receiving hate speech. Likewise, each additional moral-emotional word increased the odds of receiving hate speech by between 9.35 and 20.63%. Across the three domains, the effect sizes were most pronounced for activists. A possible reason is that the activists in our data were affiliated with politically left-leaning subjects (climate, animal rights, and LGBTQIA+) that may have been particularly likely to trigger hate speech from right-wing groups. In contrast, our data for politicians and newspeople were fairly balanced and encompassed users from both sides of the political spectrum. Overall, the comparatively large effect sizes underscore the salient role of moralized language on social media. While earlier research has demonstrated that moralized language is associated with greater virality, our work implies that it fosters the proliferation of hate speech.