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

Wednesday, March 29, 2023

Houston Christian U Sues Tim Clinton & American Assoc of Christian Counselors for Fraud & Breach of Contract

Rebecca Hopkins
The Roys Report
Originally posted 21 MAR 23

Houston Christian University (HCU) once planned to name its mental health program after Tim Clinton, president of the American Association of Christian Counselors (AACC)—the world’s leading Christian counseling organization. Now HCU is suing Clinton, the AACC, and their related organizations for $1 million, accusing them of fraud, breach of contract, and concealing Clinton’s alleged plagiarism.

AACC “knew of Dr. Clinton’s practice of plagiarizing but failed to disclose the same to Plaintiff, knowing of the importance of academic honesty to any institution of higher learning,” the suit says. “. . . Yet, AACC still entered into several agreements with Plaintiff while not disclosing the academic honesty.”

In 2016-17, HCU (then named Houston Baptist University) hired Tim Clinton and the 50,000-member AACC for more than $5 million, multiple agreements show.

As part of the agreements, Clinton and the AACC promised to deliver new enrollments to the private Baptist school and to develop 50 new courses for HCU’s counseling program. The school also contracted with Clinton to help start, lead, and promote a global mental health center at HCU for an additional payment of $26,000 per month.

However, according to the lawsuit filed March 3 in Harris County District Court in Texas, Clinton and the AACC failed to deliver “on the expressed scope of the contracts.”

The contract expressed a goal of 133 new enrollments, but AACC delivered only one student, the suit says. Plus, the new courses were supposed to be written by the AACC, the suit adds, but instead AACC outsourced the courses to a third party.

Additionally, during the time of the agreement, Clinton was accused of plagiarism. In 2018, Grove City College psychology professor Warren Throckmorton accused Clinton of plagiarism in articles Clinton posted on Medium.

Clinton attributed the issues to the use of research assistants and graduate students, as well as a former employee’s poor standards, and third-party partners’ mistakes.

Tuesday, March 28, 2023

Medical assistance in dying (MAiD): Ethical considerations for psychologists

Koocher, G. P., Benjamin, G. A. H.,  et al. (2023). 
Professional Psychology: 
Research and Practice, 54(1), 2–13.

Abstract

Significant ethical challenges arise when mental health practitioners care for patients who seek to accelerate their own dying for rational medically valid reasons. Current and proposed laws provide for medical assistance in dying (MAiD) in several U.S. jurisdictions, all of Canada, and several other nations. Differing provisions of these laws complicate their utility for some patients who seek aid in dying. Some extant laws include roles that mental health professionals might play in assessing patients’ competence or capacity to consent, mental illness, or other cognitive and behavioral factors. Practitioners who choose to accept roles in the MAiD process must consider and resolve a number of ethical challenges including potential conflicts between and among laws, ethical standards, third-party requests, personal values, and patients’ wishes. These include becoming aware of patients who may wish to act independently to end their lives when MAiD laws might otherwise exclude them. Examples from actual cases and the resultant discussion will form a basis for exploration of the ethical and legal complexities confronted when psychologists become engaged in the process either intentionally or incidentally. The lead article (Koocher) is not intended to comprehensively address MAiD in all of its complexity but rather to trigger a thoughtful discussion among the accompanying commentaries.

Impact Statement

Public Significance Statement—Current and proposed laws provide for medical assistance in dying (MAiD), sometimes described as physician-assisted suicide, in several U.S. jurisdictions, all of Canada, and in several other nations. Some such laws require psychological input, usually from either a psychologist or a psychiatrist. The limited scope of existing laws may result in some patients suffering with debilitating, painful, chronic, and fatal illnesses to consider suicide without medical assistance. With or without MAiD legislation, mental health professionals will come in contact with such patients and must consider the potentially complex ethical ramifications of caring for such patients. 

Conclusion

The culture of dying in America too often involves end-of-life care provided by strangers in institutional settings. Government and professional regulators often assume a parentalistic stance that effectively diminishes personal control of the dying process. Legalized MAiD offers an important option to those suffer from an irremediable medical condition and desire access to medical procedures to hasten death in a peaceful and dignified manner. Patients confronting chronic terminal illness have legitimate interests in controlling their own dying with quality care and support. Perhaps the most valuable and meaningful aspect of dying would include the presence of a community of care that demonstrates to the dying person that they will not feel abandoned (Campbell, 2019). Psychologists can play a significant role in making this happen. Ethical, professional, and legal controversies will abound as MAiD becomes more socially prevalent, and it will.

Monday, March 27, 2023

White Supremacist Networks Gab and 8Kun Are Training Their Own AI Now

David Gilbert
Vice News
Originally posted 22 FEB 23

Here are two excerpts:

Artificial intelligence is everywhere right now, and many are questioning the safety and morality of the AI systems released by some of the world’s biggest companies, including Open AI’s ChatGPT, Bing’s Sydney, and Google’s Bard. It was only a matter of time until the online spaces where extremists gather became interested in the technology.

Gab is a social network filled with homophobic, christian nationalist and white supremacist content. On Tuesday its CEO Andrew Torba announced the launch of its AI image generator, Gabby.

“At Gab, we have been experimenting with different AI systems that have popped up over the past year,” Torba wrote in a statement. “Every single one is skewed with a liberal/globalist/talmudic/satanic worldview. What if Gab AI Inc builds a Gab .ai (see what I did there?) that is based, has no ‘hate speech” filters and doesn’t obfuscate and distort historical and Biblical Truth?”

Gabby is currently live on Gab’s site and available to all members. Like Midjourney and DALL-E, it is an image generator that users interact with by sending it a prompt, and within seconds it will generate entirely new images based on that prompt.

Echoing his past criticisms of Big Tech platforms like Facebook and Twitter, Torba claims that mainstream platforms are now “censoring” their AI systems to prevent people from discussing right-wing topics such as Christian nationalism. Torba’s AI, by contrast, will have ”the ability to speak freely without the constraints of liberal propaganda wrapped tightly around its neck.”

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8chan, which was founded to support the Gamergate movement, became the home of QAnon in early 2018 and was taken offline in August 2019 after the man who killed 20 people at an El Paso Walmart posted an anti-immigrant screed on the site.

Watkins has been speaking about his AI system for a few weeks now, but has yet to reveal how it will work or when it will launch. Watkins’ central selling point, like Torba’s, appears to be that his system will be “uncensored.”

“So that we can compete against these people that are putting up all of these false flags and illusions,” Watkins said on Feb. 13 when he was asked why he was creating an AI system.  “We are working on our own AI that is going to give you an uncensored look at the way things are going,” Watkins said in a video interview at the end of January.But based on some of the images the engine is churning out, Watkins still has a long way to go to perfect his AI image generator.

Sunday, March 26, 2023

State medical board chair Dr. Brian Hyatt resigns, faces Medicaid fraud allegations

Ashley Savage
Arkansas Democrat Gazette
Originally published 3 MAR 23

Dr. Brian Hyatt stepped down as chairman of the Arkansas State Medical Board Thursday in a special meeting following "credible allegations of fraud," noted in a letter from the state's office of Medicaid inspector general.

Members of the board met remotely Thursday with only one item on the agenda: "Discussion of Arkansas State Board's leadership."

The motion to approve Hyatt's request to step down as chairman and out of an executive role on the board was approved unanimously.

Board members also decided that Dr. Rhys Branman will take over as the interim chairman until an election to fill the seat is held in April.

According to the board Thursday, the vacant seats for vice chair and chair of the board will be voted on separate ballots in the April elections.

The Medicaid letter states "red flags" were discovered in Hyatt's use of Medicaid claims and process of billing for medical services. In Arkansas, Medicaid fraud resulting in an overpayment over $2,500 is a felony.

"Dr. Hyatt is a clear outlier, and his claims are so high they skew the averages on certain codes for the entire Medicaid program in Arkansas," the affidavit states.

"The suspension is temporary and there's a right to appeal. I see only allegations and I don't see any actual charges and I haven't dealt with this a lot," said Branman.

Hyatt has 30 days to appeal his suspension from the Medicaid program.

Other information from the letter shows that Hyatt is alleged to have billed more Medicaid patients at the 99233 code than any other doctor billed for all of their Medicaid patients between January of 2019 and June 30, 2022.

Saturday, March 25, 2023

A Christian Health Nonprofit Saddled Thousands With Debt as It Built a Family Empire Including a Pot Farm, a Bank and an Airline

Ryan Gabrielson & J. David McSwane
ProPublic.org
Originally published 25 FEB 23

Here is an excerpt:

Four years after its launch in 2014, the ministry enrolled members in almost every state and collected $300 million in annual revenue. Liberty used the money to pay at least $140 million to businesses owned and operated by Beers family members and friends over a seven-year period, the investigation found. The family then funneled the money through a network of shell companies to buy a private airline in Ohio, more than $20 million in real estate holdings and scores of other businesses, including a winery in Oregon that they turned into a marijuana farm. The family calls this collection of enterprises “the conglomerate.”

Beers has disguised his involvement in Liberty. He has never been listed as a Liberty executive or board member, and none of the family’s 50-plus companies or assets are in his name, records show.

From the family’s 700-acre ranch north of Canton, however, Beers acts as the shadow lord of a financial empire. It was built from money that people paid to Liberty, Beers’ top lieutenant confirmed to ProPublica. He plays in high-stakes poker tournaments around the country, travels to the Caribbean and leads big-game hunts at a vast hunting property in Canada, which the family partly owns. He is a man, said one former Liberty executive, with all the “trappings of large money coming his way.”

Despite abundant evidence of fraud, much of it detailed in court records and law enforcement files obtained by ProPublica, members of the Beers family have flourished in the health care industry and have never been prevented from running a nonprofit. Instead, the family’s long and lucrative history illustrates how health care sharing ministries thrive in a regulatory no man’s land where state insurance commissioners are barred from investigating, federal agencies turn a blind eye and law enforcement settles for paltry civil settlements.

The Ohio attorney general has twice investigated Beers for activities that financial crimes investigators said were probable felonies. Instead, the office settled for civil fines, most recently in 2021. It also required Liberty to sever its ties to some Beers family members.

The IRS has pursued individual family members for underreporting their income and failing to pay million-dollar tax bills. But there’s no indication that the IRS has investigated how several members of one family amassed such substantial wealth in just seven years by running a Christian nonprofit.

The agencies’ failure to move decisively against the Beers family has left Liberty members struggling with millions of dollars in medical debt. Many have joined a class-action lawsuit accusing the nonprofit of fraud.

After years of complaints, health care sharing ministries are now attracting more scrutiny. Sharity Ministries, once among the largest organizations in the industry, filed for bankruptcy and then dissolved in 2021 as regulators in multiple states investigated its failure to pay members’ bills. In January, the Justice Department seized the assets of a small Missouri-based ministry, Medical Cost Sharing Inc., and those of its founders, accusing them of fraud and self-enrichment. The founders have denied the government’s allegations.

Friday, March 24, 2023

Psychological Features of Extreme Political Ideologies

van Prooijen, J.-W., & Krouwel, A. P. M. (2019).
Current Directions in Psychological Science, 
28(2), 159–163. 
https://doi.org/10.1177/0963721418817755

Abstract

In this article, we examine psychological features of extreme political ideologies. In what ways are political left- and right-wing extremists similar to one another and different from moderates? We propose and review four interrelated propositions that explain adherence to extreme political ideologies from a psychological perspective. We argue that (a) psychological distress stimulates adopting an extreme ideological outlook; (b) extreme ideologies are characterized by a relatively simplistic, black-and-white perception of the social world; (c) because of such mental simplicity, political extremists are overconfident in their judgments; and (d) political extremists are less tolerant of different groups and opinions than political moderates. In closing, we discuss how these psychological features of political extremists increase the likelihood of conflict among groups in society.

Discussion

The four psychological features discussed here suggest that political extremism is fueled by feelings of distress and is reflected in cognitive simplicity, overconfidence, and intolerance. These insights are important to understanding how political polarization increases political instability and the likelihood of conflict between groups in society. Excessive confidence in the moral superiority of one’s own ideological beliefs impedes meaningful interaction and cooperation with different ideological groups and structures political decision making as a zero-sum game with winners and losers. Strong moral convictions consistently decrease people’s ability to compromise and even increase a willingness to use violence to reach ideological goals (Skitka, 2010). These processes are exacerbated by people’s tendency to selectively expose themselves to people and ideas that validate their own convictions. For instance, both information and misinformation selectively spread in online echo chambers of like-minded people (Del Vicario et al., 2016).

This article extends current insights in at least three ways. First, the features proposed here help to explain why throughout the past century not only extreme-right but also extreme-left movements (e.g., socialism, communism) have thrived in times of crisis (Midlarsky, 2011). Second, understanding the mind-set of extremists in all corners of the political spectrum is important in times of polarization and populist rhetoric. The current propositions provide insights into why traditionally moderate parties in the EU have suffered substantial electoral losses. In particular, the support for well-established parties on the moderate left (e.g., social democrats) and moderate right (e.g., Christian democrats) has dropped in recent years, whereas the support for left- and right-wing populist parties has increased (Krouwel, 2012). Third, the present arguments are based on evidence from multiple countries with different political systems (van Prooijen & Krouwel, 2017), which suggests that they apply to both two-party systems (e.g., the United States) and multiparty systems (e.g., many European countries).

Thursday, March 23, 2023

Are there really so many moral emotions? Carving morality at its functional joints

Fitouchi L., André J., & Baumard N.
To appear in L. Al-Shawaf & T. K. Shackelford (Eds.)
The Oxford Handbook of Evolution and the Emotions.
New York: Oxford University Press.

Abstract

In recent decades, a large body of work has highlighted the importance of emotional processes in moral cognition. Since then, a heterogeneous bundle of emotions as varied as anger, guilt, shame, contempt, empathy, gratitude, and disgust have been proposed to play an essential role in moral psychology.  However, the inclusion of these emotions in the moral domain often lacks a clear functional rationale, generating conflations between merely social and properly moral emotions. Here, we build on (i) evolutionary theories of morality as an adaptation for attracting others’ cooperative investments, and on (ii) specifications of the distinctive form and content of moral cognitive representations. On this basis, we argue that only indignation (“moral anger”) and guilt can be rigorously characterized as moral emotions, operating on distinctively moral representations. Indignation functions to reclaim benefits to which one is morally entitled, without exceeding the limits of justice. Guilt functions to motivate individuals to compensate their violations of moral contracts. By contrast, other proposed moral emotions (e.g. empathy, shame, disgust) appear only superficially associated with moral cognitive contents and adaptive challenges. Shame doesn’t track, by design, the respect of moral obligations, but rather social valuation, the two being not necessarily aligned. Empathy functions to motivate prosocial behavior between interdependent individuals, independently of, and sometimes even in contradiction with the prescriptions of moral intuitions. While disgust is often hypothesized to have acquired a moral role beyond its pathogen-avoidance function, we argue that both evolutionary rationales and psychological evidence for this claim remain inconclusive for now.

Conclusion

In this chapter, we have suggested that a specification of the form and function of moral representations leads to a clearer picture of moral emotions. In particular, it enables a principled distinction between moral and non-moral emotions, based on the particular types of cognitive representations they process. Moral representations have a specific content: they represent a precise quantity of benefits that cooperative partners owe each other, a legitimate allocation of costs and benefits that ought to be, irrespective of whether it is achieved by people’s actual behaviors. Humans intuit that they have a duty not to betray their coalition, that innocent people do not deserve to be harmed, that their partner has a right not to be cheated on. Moral emotions can thus be defined as superordinate programs orchestrating cognition, physiology and behavior in accordance with the specific information encoded in these moral representations.    On this basis, indignation and guilt appear as prototypical moral emotions. Indignation (“moral anger”) is activated when one receives fewer benefits than one deserves, and recruits bargaining mechanisms to enforce the violated moral contract. Guilt, symmetrically, is sensitive to one’s failure to honor one’s obligations toward others, and motivates compensation to provide them the missing benefits they deserve. By contrast, often-proposed “moral” emotions – shame, empathy, disgust – seem not to function to compute distinctively moral representations of cooperative obligations, but serve other, non-moral functions – social status management, interdependence, and pathogen avoidance (Figure 2). 

Wednesday, March 22, 2023

Young children show negative emotions after failing to help others

Gerdemann, S. C., Tippmann, J., et al (2022). 
PloS one, 17(4), e0266539.
https://doi.org/10.1371/journal.pone.0266539

Abstract

Self-conscious emotions, such as guilt and shame, motivate the adherence to social norms, including to norms for prosociality. The relevance of an observing audience to the expression of negative self-conscious emotions remains poorly understood. Here, in two studies, we investigated the influence of being observed on 4-to 5-year-old children's (N = 161) emotional response after failing to help someone in need and after failing to complete their own goal. As an index of children's emotional response, we recorded the change in children's upper body posture using a motion depth sensor imaging camera. Failing to help others lowered children's upper body posture regardless of whether children were observed by an audience or not. Children's emotional response was similar when they failed to help and when they failed to complete their own goal. In Study 2, 5-year-olds showed a greater decrease in upper body posture than 4-year-olds. Our findings suggest that being observed is not a necessary condition for young children to express a negative self-conscious emotion after failing to help or after failing to complete their own goal. We conclude that 5-year-olds, more so that 4-year-olds, show negative emotions when they fail to adhere to social norms for prosociality.

General discussion

The current studies represent the first investigation of children’s emotional response to failing to help others using a method that automatically and objectively record changes in children’s body posture. Our studies show that young children’s emotional response is similarly negative when they fail to help or fail to achieve their own goal in both an observed and unobserved set-ting. Specifically, in both studies, children expressed a greater reduction in upper body posture after they failed to help (Trial 1) than during the resolution of the situation moments later (Trial 2). This result was corroborated by the emotion valence coding of Study 1. While observation or goal context did not influence this emotional response, we did find evidence in Study2 that 5-year-olds expressed a greater reduction in upper body posture after failing to help than 4-year-olds. Moreover, in Study 2, children expressed a predominantly shame-like negative emotion after failing to help, suggesting that self-evaluative processes were involved in children’s emotional response.

The influence of observation

Children expressed similarly negative emotions regardless of whether they were observed or unobserved during a failure to help, suggesting that the presence of an audience is not required for young children to express a negative self-conscious emotion. It is worth noting that children were made aware of the observer’s presence twice during the studies and were told that the observer would watch them today, which is comparable to previous studies of the influence of observation on children’s prosocial behavior. Our findings thus raise questions about the role of others’ evaluation or judgment of oneself in young children’s expression of self-conscious emotions. Some scholars have argued that young children’s expression of shame following achievement-related failures is the result of observing adults knowing (or having the impression) that children have performed poorly until children are school-aged.

Tuesday, March 21, 2023

Mitigating welfare-related prejudice and partisanship among U.S. conservatives with moral reframing of a universal basic income policy

Thomas, C. C., Walton, G. M., et al.
Journal of Experimental Social Psychology
Volume 105, March 2023, 104424

Abstract

Inequality and deep poverty have risen sharply in the US since the 1990s. Simultaneously, cash-based welfare policies have frayed, support for public assistance has fallen on the political right, and prejudice against recipients of welfare has remained high. Yet, in recent years Universal Basic Income (UBI) has gained traction, a policy proposing to give all citizens cash sufficient to meet basic needs with no strings attached. We hypothesized that UBI can mitigate the partisanship and prejudice that define the existing welfare paradigm in the US but that this potential depends critically on the narratives attached to it. Indeed, across three online experiments with US adults (total N = 1888), we found that communicating the novel policy features of UBI alone were not sufficient to achieve bipartisan support for UBI or overcome negative stereotyping of its recipients. However, when UBI was described as advancing the more conservative value of financial freedom, conservatives perceived the policy to be more aligned with their values and were less opposed to the policy (meta-analytic effect on policy support: d = 0.36 [95% CI: 0.27 to 0.46]). Extending the literatures on moral reframing and cultural match, we further find that this values-aligned policy narrative mitigated prejudice among conservatives, reducing negative welfare-related stereotyping of policy recipients (meta-analytic effect d = −0.27 [95% CI: −0.38 to −0.16]), while increasing affiliation with them. Together, these findings point to moral reframing as a promising means by which institutional narratives can be used to bridge partisan divides and reduce prejudice.

Highlights

• Policies like Universal Basic Income (UBI) propose to mitigate poverty and inequality by giving all citizens cash

• A UBI policy narrative based in freedom most increased policy support and reduced prejudice among conservatives

• This narrative also achieved the highest perceived moral fit, or alignment with one’s values, among conservatives

• Moral reframing of policy communications may be an effective institutional lever for mitigating partisanship and prejudice

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General discussion

Three experiments revealed that a values-based narrative of UBI, one grounded in the conservative value of economic freedom, can advance bipartisanship in support for UBI and simultaneously mitigate welfare-related prejudice among U.S. conservatives. While policy reforms often focus on changes to objective policy features, these studies suggest that the narratives attached to such features will meaningfully influence public attitudes towards both the policy and its recipients. In other words, the potential of policies like UBI to advance goals such as inequality reduction and prejudice mitigation may be limited if they fail to attend to the narratives that accompany them.

Here, we demonstrate the potential for policy narratives that elevate the moral foundations of those most opposed to the policy, U.S. conservatives in this case. Why might this narrative approach succeed? At a higher-order level, our findings suggests that inclusion begets inclusion: when conservatives felt that the policy recognized and reflected their own values, they were more likely to support the policy and express inclusive attitudes toward its recipients.