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, August 31, 2023

It’s not only political conservatives who worry about moral purity

K. Gray, W. Blakey, & N. DiMaggio
psychce.co
Originally posted 13 July 23

Here are two excerpts:

What does this have to do with differences in moral psychology? Well, moral psychologists have suggested that politically charged arguments about sexuality, spirituality and other subjects reflect deep differences in the moral values of liberals and conservatives. Research involving scenarios like this one has seemed to indicate that conservatives, unlike liberals, think that maintaining ‘purity’ is a moral good in itself – which for them might mean supporting what they construe as the ‘sanctity of marriage’, for example.

It may seem strange to think about ‘purity’ as a core driver of political differences. But purity, in the moral sense, is an old concept. It pops up in the Hebrew Bible a lot, in taboos around food, menstruation, and divine encounters. When Moses meets God at the Burning Bush, God says to Moses: ‘Do not come any closer, take off your sandals, for the place where you are standing is holy ground.’ Why does God tell Moses to take off his shoes? Not because his shoes magically hurt God, but because shoes are dirty, and it’s disrespectful to wear your shoes in the presence of the creator of the universe. Similarly, in ancient Greece, worshippers were often required to endure long purification rituals before looking at sacred religious idols or engaging in different spiritual rites. These ancient moral practices seem to reflect an intuition that ‘cleanliness is next to Godliness’.

In the modern era, purity has repeatedly appeared at the centre of political battlegrounds, as in clashes between US conservatives and liberals over sexual education and mores in the 1990s. It was around this time that the psychologist Jonathan Haidt began formulating a theory to help explain the moral divide. Moral foundations theory argues that liberals and conservatives are divided because they rely on distinct moral values, including purity, to different degrees.

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A harm-focused perspective on moral judgments related to ‘purity’ could help us better understand and communicate with moral opponents. We all grasp the importance of protecting ourselves and our loved ones from harm. Learning that people on the ‘other side’ of a political divide care about questions of purity because they connect these to their understanding of harm can help us empathise with different moral opinions. It is easy for a liberal to dismiss a conservative’s condemnation of dead-chicken sex when it is merely said to be ‘impure’; it is harder to be dismissive if it’s suggested that someone who makes a habit of that behaviour might end up harming people.

Explicitly grounding discussions of morality in perceptions of harm could help us all to be better citizens of a ‘small-L liberal’ society – one in which the right to swing our fists ends where others’ noses begin. If something seems disgusting, impure and immoral to you, take some time to try to articulate the harms you intuitively perceive. Talking about these potential harms may help other people understand where you are coming from. Of course, someone might not share your judgment that harm is being done. But identifying perceived harms at least puts the conversation in terms that everyone understands.


Here is my summary:

The authors define purity as "the state of being free from contamination or pollution."  They argue that people on both the left and the right care about purity because they associate it with safety and well-being.
They provide examples of how liberals and conservatives can both use purity-related language, such as "desecrate" and "toxic." They propose a new explanation of moral judgments that suggests that people care about purity when they perceive that 'impure' acts can lead to harm.

Wednesday, August 30, 2023

Not all skepticism is “healthy” skepticism: Theorizing accuracy- and identity-motivated skepticism toward social media misinformation

Li, J. (2023). 
New Media & Society, 0(0). 

Abstract

Fostering skepticism has been seen as key to addressing misinformation on social media. This article reveals that not all skepticism is “healthy” skepticism by theorizing, measuring, and testing the effects of two types of skepticism toward social media misinformation: accuracy- and identity-motivated skepticism. A two-wave panel survey experiment shows that when people’s skepticism toward social media misinformation is driven by accuracy motivations, they are less likely to believe in congruent misinformation later encountered. They also consume more mainstream media, which in turn reinforces accuracy-motivated skepticism. In contrast, when skepticism toward social media misinformation is driven by identity motivations, people not only fall for congruent misinformation later encountered, but also disregard platform interventions that flag a post as false. Moreover, they are more likely to see social media misinformation as favoring opponents and intentionally avoid news on social media, both of which form a vicious cycle of fueling more identity-motivated skepticism.

Discussion

I have made the case that it is important to distinguish between accuracy-motivated skepticism and identity-motivated skepticism. They are empirically distinguishable constructs that cast opposing effects on outcomes important for a well-functioning democracy. Across the board, accuracy-motivated skepticism produces normatively desirable outcomes. Holding a higher level of accuracy-motivated skepticism makes people less likely to believe in congruent misinformation they encounter later, offering hope that partisan motivated reasoning can be attenuated. Accuracy-motivated skepticism toward social media misinformation also has a mutually reinforcing relationship with consuming news from mainstream media, which can serve to verify information on social media and produce potential learning effects.

In contrast, not all skepticism is “healthy” skepticism. Holding a higher level of identity-motivated skepticism not only increases people’s susceptibility to congruent misinformation they encounter later, but also renders content flagging by social media platforms less effective. This is worrisome as calls for skepticism and platform content moderation have been a crucial part of recently proposed solutions to misinformation. Further, identity-motivated skepticism reinforces perceived bias of misinformation and intentional avoidance of news on social media. These can form a vicious cycle of close-mindedness and politicization of misinformation.

This article advances previous understanding of skepticism by showing that beyond the amount of questioning (the tipping point between skepticism and cynicism), the type of underlying motivation matters for whether skepticism helps people become more informed. By bringing motivated reasoning and media skepticism into the same theoretical space, this article helps us make sense of the contradictory evidence on the utility of media skepticism. Skepticism in general should not be assumed to be “healthy” for democracy. When driven by identity motivations, skepticism toward social media misinformation is counterproductive for political learning; only when skepticism toward social media is driven by the accuracy motivations does it inoculate people against favorable falsehoods and encourage consumption of credible alternatives.


Here are some additional thoughts on the research:
  • The distinction between accuracy-motivated skepticism and identity-motivated skepticism is a useful one. It helps to explain why some people are more likely to believe in misinformation than others.
  • The findings of the studies suggest that interventions that promote accuracy-motivated skepticism could be effective in reducing the spread of misinformation on social media.
  • It is important to note that the research was conducted in the United States. It is possible that the findings would be different in other countries.

Tuesday, August 29, 2023

Yale University settles lawsuit alleging it pressured students with mental health issues to withdraw

Associated Press
Originally posted 25 Aug 23

Yale University and a student group announced Friday that they've reached a settlement in a federal lawsuit that accused the Ivy League school of discriminating against students with mental health disabilities, including pressuring them to withdraw.

Under the agreement, Yale will modify its policies regarding medical leaves of absence, including streamlining the reinstatement process for students who return to campus. The student group, which also represents alumni, had argued the process was onerous, discouraging students for decades from taking medical leave when they needed it most.

The settlement is a “watershed moment” for the university and mental health patients, said 2019 graduate Rishi Mirchandani, a co-founder of Elis for Rachael, the group that sued. It was formed to help students with mental health issues in honor of a Yale student who took her own life.

“This historic settlement affirms that students with mental health needs truly belong," Mirchandani said.

A joint statement from Elis for Rachael and Yale, released on Friday, confirmed the agreement "to resolve a lawsuit filed last November in federal district court related to policies and practices impacting students with mental health disabilities.”

Under the agreement, Yale will allow students to study part-time if they have urgent medical needs. Elis for Rachael said it marks the first time the university has offered such an option. Students granted the accommodation at the beginning of a new term will receive a 50% reduction in tuition.

“Although Yale describes the circumstances for this accommodation as ‘rare,’ this change still represents a consequential departure from the traditional all-or-nothing attitude towards participation in academic life at Yale,” the group said in a statement.

The dean of Yale College, Pericles Lewis, said he was “pleased with today’s outcome.”


The potential good news: The lawsuit against Yale is a step towards ensuring that students with mental health disabilities have the same opportunities as other students. It is also a reminder that colleges and universities have a responsibility to create a supportive environment for all students, regardless of their mental health status.

Monday, August 28, 2023

'You can't bullshit a bullshitter' (or can you?): Bullshitting frequency predicts receptivity to various types of misleading information

Littrell, S., Risko, E. F., & Fugelsang, J. A. (2021).
The British journal of social psychology, 60(4), 
1484–1505.

Abstract

Research into both receptivity to falling for bullshit and the propensity to produce it have recently emerged as active, independent areas of inquiry into the spread of misleading information. However, it remains unclear whether those who frequently produce bullshit are inoculated from its influence. For example, both bullshit receptivity and bullshitting frequency are negatively related to cognitive ability and aspects of analytic thinking style, suggesting that those who frequently engage in bullshitting may be more likely to fall for bullshit. However, separate research suggests that individuals who frequently engage in deception are better at detecting it, thus leading to the possibility that frequent bullshitters may be less likely to fall for bullshit. Here, we present three studies (N = 826) attempting to distinguish between these competing hypotheses, finding that frequency of persuasive bullshitting (i.e., bullshitting intended to impress or persuade others) positively predicts susceptibility to various types of misleading information and that this association is robust to individual differences in cognitive ability and analytic cognitive style.

Conclusion

Gaining a better understanding of the differing ways in which various types of misleading information are transmitted and received is becoming increasingly important in the information age (Kristansen & Kaussler, 2018). Indeed, an oft-repeated maxim in popular culture is, “you can’t bullshit a bullshitter.” While folk wisdom may assert that this is true, the present investigation suggests that the reality is a bit more complicated. Our primary aim was to examine the extent to which bullshitting frequency is associated with susceptibility to falling for bullshit. Overall, we found that persuasive bullshitters (but not evasive bullshitters) were more receptive to various types of bullshit and, in the case of pseudo-profound statements, even when controlling for factors related to intelligence and analytic thinking. These results enrich our understanding of the transmission and detection of certain types of misleading information, specifically the associations between the propensity to produce and the tendency to fall for bullshit and will help to inform future research in this growing area of scholarship.



Sunday, August 27, 2023

Ontario court rules against Jordan Peterson, upholds social media training order

Canadian Broadcasting Company
Originally posted 23 August 23

An Ontario court ruled against psychologist and media personality Jordan Peterson Wednesday, and upheld a regulatory body's order that he take social media training in the wake of complaints about his controversial online posts and statements.

Last November, Peterson, a professor emeritus with the University of Toronto psychology department who is also an author and media commentator, was ordered by the College of Psychologists of Ontario to undergo a coaching program on professionalism in public statements.

That followed numerous complaints to the governing body of Ontario psychologists, of which Peterson is a member, regarding his online commentary directed at politicians, a plus-sized model, and transgender actor Elliot Page, among other issues. You can read more about those social media posts here.

The college's complaints committee concluded his controversial public statements could amount to professional misconduct and ordered Peterson to pay for a media coaching program — noting failure to comply could mean the loss of his licence to practice psychology in the province.

Peterson filed for a judicial review, arguing his political commentary is not under the college's purview.

Three Ontario Divisional Court judges unanimously dismissed Peterson's application, ruling that the college's decision falls within its mandate to regulate the profession in the public interest and does not affect his freedom of expression.

"The order is not disciplinary and does not prevent Dr. Peterson from expressing himself on controversial topics; it has a minimal impact on his right to freedom of expression," the decision written by Justice Paul Schabas reads, in part.



My take:

Peterson has argued that the order violates his right to free speech. He has also said that the complaints against him were politically motivated. However, the court ruled that the college's order was justified in order to protect the public from harm.

The case of Jordan Peterson is a reminder that psychologists, like other human beings, are not infallible. They are capable of making mistakes and of expressing harmful views. It is important to hold psychologists accountable for their actions, and to ensure that they are held to the highest ethical standards.

In addition to the steps outlined above, there are a number of other things that can be done to mitigate bias in psychology. These include:
  • Increasing diversity in the field of psychology
  • Promoting critical thinking and self-reflection among psychologists
  • Developing more specific ethical guidelines for psychologists' use of social media
  • Holding psychologists accountable for their online behavior

Saturday, August 26, 2023

Can Confirmation Bias Improve Group Learning?

Gabriel, N. and O'Connor, C. (2022)
[Preprint]

Abstract

Confirmation bias has been widely studied for its role in failures of reasoning. Individuals exhibiting confirmation bias fail to engage with information that contradicts their current beliefs, and, as a result, can fail to abandon inaccurate beliefs. But although most investigations of confirmation bias focus on individual learning, human knowledge is typically developed within a social structure. How does the presence of confirmation bias influence learning and the development of consensus within a group? In this paper, we use network models to study this question. We find, perhaps surprisingly, that moderate confirmation bias often improves group learning. This is because confirmation bias leads the group to entertain a wider variety of theories for a longer time, and prevents them from prematurely settling on a suboptimal theory. There is a downside, however, which is that a stronger form of confirmation bias can cause persistent polarization, and hurt the knowledge producing capacity of the community. We discuss implications of these results for epistemic communities, including scientific ones.

Conclusion

We find that confirmation bias, in a more moderate form, improves the epistemic performance of agents in a networked community. This is perhaps surprising given that previous work mostly emphasizes the epistemic harms of confirmation bias. By decreasing the chances that a group pre-emptively settles on a
promising theory or option, confirmation bias can improve the likelihood that the group chooses optimal options in the long run. In this, it can play a similar role to decreased network connectivity or stubbornness (Zollman, 2007, 2010; Wu, 2021). The downside is that more robust confirmation bias, where agents entirely ignore data that is too disconsonant with their current beliefs, can lead to polarization, and harm the epistemic success of a community. Our modeling results thus provide potential support for the arguments of Mercier & Sperber (2017) regarding the benefits of confirmation bias to a group, but also a caution.  Too much confirmation bias does not provide such benefits.

There are several ongoing discussions in philosophy and the social sciences where these results are relevant. Mayo-Wilson et al. (2011) use network models to argue for the independence thesis—that rationality of individual agents and rationality of the groups they form sometimes come apart. I.e., individually rational agents may form groups which are not ideally rational, and rational groups may sometimes consist in individually irrational agents. Our results lend support to this claim. While there is a great deal of evidence suggesting that confirmation bias is not ideal for individual reasoners, our results suggest that it can nonetheless improve group reasoning under the right conditions.


The authors conclude that confirmation bias can have both positive and negative effects on group learning. The key is to find a moderate level of confirmation bias that allows the group to explore a variety of theories without becoming too polarized.

Here are some of the key findings of the paper:
  • Moderate confirmation bias can improve group learning by preventing the group from prematurely settling on a suboptimal theory.
  • Too much confirmation bias can lead to polarization and a decrease in the group's ability to learn.
  • The key to effective group learning is to find a moderate level of confirmation bias.

Friday, August 25, 2023

The cognitive foundations of ideological orthodoxy: Threat avoidance, ingroup mobilization, & signaling

Marie, A., & Petersen, M. (2023, March 10).

Abstract

Political and religious movements often bind around shared mobilizing narratives. In their most devoted activists, this triggers moral motivations to affirm and protect the narrative from being argumentatively challenged (i.e., orthodox mindsets), with free expression and nuance as the primary casualties. The ideological narratives are often threat-based, denouncing an evil or villains encroaching on a sacred value, such as national grandeur, the faith, or class, racial, or gender equality. Their protection triggers repressive reactions ranging from expressions of outrage or public shaming on social media to the “deplatforming” of controversial speakers to censorship and imprisonment of dissidents. Orthodox mindsets are puzzling because of the often disproportionate righteousness with which they try to protect cherished narratives. We suspect that orthodox mindsets may derive from three main evolved cognitive foundations. First, over-sensitive dispositions to detect threat, from human outgroups in particular. Second, motivations to mobilize ingroup members for cooperative benefits and against rival groups by emphasizing goals relevant to everyone. Third, signaling personal devotion to causes one’s allies value to accrue prestige within the ingroup. In line with arguments about self-deception, strategies of ingroup mobilization and signaling may be most likely to meet their evolved functions when displayed by activists sincerely committed to the ideological movement’s tenets.

Highlights:
  • Devout activists of political and religious movements often display moral motivations to repress critiques of mobilizing narratives
  • The protected narratives are often rigid and hard-to-falsify accounts of a social threat
  • We propose that such orthodox mindsets tap at least three evolved cognitive systems: threat  (over) detection and attempts to mobilize the ingroup and acquire status (signaling)
  • Cognitive systems of mobilization and signaling pursue social goals, that may be more likely to be reached when activists endorse the threat-based narrative sincerely, and view its truth as identity-defining
Conclusion

Moral motivations to protect rigid and hard-to-falsify threat-based narratives from contestation is a characteristic feature of many political and religious movements.  Such orthodox mindsets may be rooted in cognitive instincts which function is to try to maintain mobilization of followers for moralized causes—fighting outgroup threats in particular—and to signal devotion to those causes to gain status. Future research should explore further the content properties that make ideological narratives compelling, the balance between their hypothetical functions of mobilizing and signaling, and the factors susceptible to moderate orthodox urges

Thursday, August 24, 2023

The Limits of Informed Consent for an Overwhelmed Patient: Clinicians’ Role in Protecting Patients and Preventing Overwhelm

J. Bester, C.M. Cole, & E. Kodish.
AMA J Ethics. 2016;18(9):869-886.
doi: 10.1001/journalofethics.2016.18.9.peer2-1609.

Abstract

In this paper, we examine the limits of informed consent with particular focus on ways in which various factors can overwhelm decision-making capacity. We introduce overwhelm as a phenomenon commonly experienced by patients in clinical settings and distinguish between emotional overwhelm and informational overload. We argue that in these situations, a clinician’s primary duty is prevention of harm and suggest ways in which clinicians can discharge this obligation. To illustrate our argument, we consider the clinical application of genetic sequencing testing, which involves scientific and technical information that can compromise the understanding and decisional capacity of most patients. Finally, we consider and rebut objections that this could lead to paternalism.

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Overwhelm and Information Overload

The claim we defend is a simple one: there are medical situations in which the information involved in making a decision is of such a nature that the decision-making capacity of a patient is overwhelmed by the sheer complexity or volume of information at hand. In such cases a patient cannot attain the understanding necessary for informed decision making, and informed consent is therefore not possible. We will support our thesis regarding informational overload by focusing specifically on the area of clinical whole genome sequencing—i.e., identification of an individual’s entire genome, enabling the identification and interaction of multiple genetic variants—as distinct from genetic testing, which tests for specific genetic variants.

We will first present ethical considerations regarding informed consent. Next, we will present three sets of factors that can burden the capacity of a patient to provide informed consent for a specific decision—patient, communication, and information factors—and argue that these factors may in some circumstances make it impossible for a patient to provide informed consent. We will then discuss emotional overwhelm and informational overload and consider how being overwhelmed affects informed consent. Our interest in this essay is mainly in informational overload; we will therefore consider whole genome sequencing as an example in which informational factors overwhelm a patient’s decision-making capacity. Finally, we will offer suggestions as to how the duty to protect patients from harm can be discharged when informed consent is not possible because of emotional overwhelm or informational overload.

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How should clinicians respond to such situations?

Surrogate decision making. One possible solution to the problem of informed consent when decisional capacity is compromised is to seek a surrogate decision maker. However, in situations of informational overload, this may not solve the problem. If the information has inherent qualities that would overwhelm a reasonable patient, it is likely to also overwhelm a surrogate. Unless the surrogate decision maker is a content expert who also understands the values of the patient, a surrogate decision maker will not solve the problem of informed consent. Surrogate decision making may, however, be useful for the emotionally overwhelmed patient who remains unable to provide informed consent despite additional support.

Shared decision making. Another possible solution is to make use of shared decision making (SDM). This approach relies on deliberation between clinician and patient regarding available health care choices, taking the best evidence into account. The clinician actively involves the patient and elicits patient values. The goal of SDM is often stated as helping patients arrive at informed decisions that respect what matters most to them.

It is not clear, however, that SDM will be successful in facilitating informed decisions when an informed consent process has failed. SDM as a tool for informed decision making is at its core dependent on the patient understanding the options presented and being able to describe the preferred option. Understanding and deliberating about what is at stake for each option is a key component of this use of SDM. Therefore, if the medical information is so complex that it overloads the patient’s decision-making capacity, SDM is unlikely to achieve informed decision making. But if a patient is emotionally overwhelmed by the illness experience and all that accompanies it, a process of SDM and support for the patient may eventually facilitate informed decision making.

Wednesday, August 23, 2023

Excess Death Rates for Republican and Democratic Registered Voters in Florida and Ohio During the COVID-19 Pandemic

Wallace J, Goldsmith-Pinkham P, Schwartz JL. 
JAMA Intern Med. 
Published online July 24, 2023.
doi:10.1001/jamainternmed.2023.1154

Key Points

Question

Was political party affiliation a risk factor associated with excess mortality during the COVID-19 pandemic in Florida and Ohio?

Findings

In this cohort study evaluating 538 159 deaths in individuals aged 25 years and older in Florida and Ohio between March 2020 and December 2021, excess mortality was significantly higher for Republican voters than Democratic voters after COVID-19 vaccines were available to all adults, but not before. These differences were concentrated in counties with lower vaccination rates, and primarily noted in voters residing in Ohio.

Meaning

The differences in excess mortality by political party affiliation after COVID-19 vaccines were available to all adults suggest that differences in vaccination attitudes and reported uptake between Republican and Democratic voters may have been a factor in the severity and trajectory of the pandemic in the US.


My Take

Beliefs are a powerful force that can influence our health behaviors. Our beliefs about health, illness, and the causes of disease can shape our decisions about what we eat, how much we exercise, and whether or not we see a doctor when we're sick.

There is a growing body of research that suggests that beliefs can have a significant impact on health outcomes. For example, one study found that people who believe that they have a strong sense of purpose in life tend to live longer than those who do not. Another study found that people who believe in a higher power tend to be more optimistic and have a more positive outlook on life, which can lead to better mental health, which can in turn have a positive impact on physical health.  However, certain beliefs may be harmful to health and longevity.

The study suggest that beliefs may play a role in the relationship between political party affiliation and excess death rates. For example, Republicans are more likely to hold beliefs that are associated with vaccine hesitancy, such as distrust of government and the medical establishment. These beliefs may have contributed to the lower vaccination rates among Republican-registered voters, which in turn may have led to higher excess death rates.