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

Friday, February 9, 2024

The Dual-Process Approach to Human Sociality: Meta-analytic evidence for a theory of internalized heuristics for self-preservation

Capraro, Valerio (May 8, 2023).
Journal of Personality and Social Psychology, 

Abstract

Which social decisions are influenced by intuitive processes? Which by deliberative processes? The dual-process approach to human sociality has emerged in the last decades as a vibrant and exciting area of research. Yet, a perspective that integrates empirical and theoretical work is lacking. This review and meta-analysis synthesizes the existing literature on the cognitive basis of cooperation, altruism, truth-telling, positive and negative reciprocity, and deontology, and develops a framework that organizes the experimental regularities. The meta-analytic results suggest that intuition favours a set of heuristics that are related to the instinct for self-preservation: people avoid being harmed, avoid harming others (especially when there is a risk of harm to themselves), and are averse to disadvantageous inequalities. Finally, this paper highlights some key research questions to further advance our understanding of the cognitive foundations of human sociality.

Here is my summary:

This article proposes a dual-process approach to human sociality.  Capraro argues that there are two main systems that govern human social behavior: an intuitive system and a deliberative system. The intuitive system is fast, automatic, and often based on heuristics, or mental shortcuts. The deliberative system is slower, more effortful, and based on a more careful consideration of the evidence.

Capraro argues that the intuitive system plays a key role in cooperation, altruism, truth-telling, positive and negative reciprocity, and deontology. This is because these behaviors are often necessary for self-preservation. For example, in order to avoid being harmed, people are naturally inclined to cooperate with others and avoid harming others. Similarly, in order to maintain positive relationships with others, people are inclined to be truthful and reciprocate favors.

The deliberative system plays a more important role in more complex social situations, such as when people need to make decisions that have long-term consequences or when they need to take into account the needs of others. In these cases, people are more likely to engage in careful consideration of the evidence and to weigh the different options before making a decision. The authors conclude that the dual-process approach to human sociality provides a framework for understanding the complex cognitive basis of human social behavior. This framework can be used to explain a wide range of social phenomena, from cooperation and altruism to truth-telling and deontology.

Thursday, February 8, 2024

People's thinking plans adapt to the problem they're trying to solve

Ongchoco, J. D., Knobe, J., & Jara-Ettinger, J. (2024).
Cognition, 243, 105669.

Abstract

Much of our thinking focuses on deciding what to do in situations where the space of possible options is too large to evaluate exhaustively. Previous work has found that people do this by learning the general value of different behaviors, and prioritizing thinking about high-value options in new situations. Is this good-action bias always the best strategy, or can thinking about low-value options sometimes become more beneficial? Can people adapt their thinking accordingly based on the situation? And how do we know what to think about in novel events? Here, we developed a block-puzzle paradigm that enabled us to measure people's thinking plans and compare them to a computational model of rational thought. We used two distinct response methods to explore what people think about—a self-report method, in which we asked people explicitly to report what they thought about, and an implicit response time method, in which we used people's decision-making times to reveal what they thought about. Our results suggest that people can quickly estimate the apparent value of different options and use this to decide what to think about. Critically, we find that people can flexibly prioritize whether to think about high-value options (Experiments 1 and 2) or low-value options (Experiments 3, 4, and 5), depending on the problem. Through computational modeling, we show that these thinking strategies are broadly rational, enabling people to maximize the value of long-term decisions. Our results suggest that thinking plans are flexible: What we think about depends on the structure of the problems we are trying to solve.


Some thoughts:

The study is based on the idea that people have "thinking plans" which are essentially roadmaps that guide our thoughts and actions when we are trying to solve a problem. These thinking plans are not static, but rather can change and adapt depending on the specific problem we are facing.

For example, if we are trying to solve a math problem, our thinking plan might involve breaking the problem down into smaller steps, identifying the relevant information, and applying the appropriate formulas. However, if we are trying to solve a social problem, our thinking plan might involve considering the different perspectives of the people involved, identifying potential solutions, and evaluating the consequences of each solution.

The study used computational modeling to simulate how people would solve different types of problems. The model showed that people's thinking plans were flexible and adapted to the specific problem at hand. The model also showed that these thinking plans were broadly rational, meaning that they helped people to make decisions that were in their best interests.

The findings of the study have important implications for education and other fields that are concerned with human decision-making. The study suggests that it is important to teach people how to think flexibly and adapt their thinking plans to different situations. It also suggests that we should not expect people to always make the "right" decision, as the best course of action will often depend on the specific circumstances.

Wednesday, February 7, 2024

Listening to bridge societal divides

Santoro, E., & Markus, H. R. (2023).
Current opinion in psychology, 54, 101696.

Abstract

The U.S. is plagued by a variety of societal divides across political orientation, race, and gender, among others. Listening has the potential to be a key element in spanning these divides. Moreover, the benefits of listening for mitigating social division has become a culturally popular idea and practice. Recent evidence suggests that listening can bridge divides in at least two ways: by improving outgroup sentiment and by granting outgroup members greater status and respect. When reviewing this literature, we pay particular attention to mechanisms and to boundary conditions, as well as to the possibility that listening can backfire. We also review a variety of current interventions designed to encourage and improve listening at all levels of the culture cycle. The combination of recent evidence and the growing popular belief in the significance of listening heralds a bright future for research on the many ways that listening can diffuse stereotypes and improve attitudes underlying intergroup division.

The article is paywalled, which is not really helpful in spreading the word.  This information can be very helpful in couples and family therapy.  Here are my thoughts:

The idea that listening can help bridge societal divides is a powerful one. When we truly listen to someone from a different background, we open ourselves up to understanding their perspective and experiences. This can help to break down stereotypes and foster empathy.

Benefits of Listening:
  • Reduces prejudice: Studies have shown that listening to people from different groups can help to reduce prejudice. When we hear the stories of others, we are more likely to see them as individuals, rather than as members of a stereotyped group.
  • Builds trust: Listening can help to build trust between people from different groups. When we show that we are willing to listen to each other, we demonstrate that we are open to understanding and respecting each other's views.
  • Finds common ground: Even when people disagree, listening can help them to find common ground. By focusing on areas of agreement, rather than on differences, we can build a foundation for cooperation and collaboration.
Challenges of Listening:

It is important to acknowledge that listening is not always easy. There are a number of challenges that can make it difficult to truly hear and understand someone from a different background. These challenges include:
  • Bias: We all have biases, and these biases can influence the way we listen to others. It is important to be aware of our own biases and to try to set them aside when we are listening to someone else.
  • Distraction: In today's world, there are many distractions that can make it difficult to focus on what someone else is saying. It is important to create a quiet and distraction-free environment when we are trying to have a meaningful conversation with someone.
  • Discomfort: Talking about difficult topics can be uncomfortable. However, it is important to be willing to listen to these conversations, even if they make us feel uncomfortable.
Tips for Effective Listening:
  • Pay attention: Make eye contact and avoid interrupting the speaker.
  • Be open-minded: Try to see things from the speaker's perspective, even if you disagree with them.
  • Ask questions: Ask clarifying questions to make sure you understand what the speaker is saying.
  • Summarize: Briefly summarize what you have heard to show that you were paying attention.
  • By practicing these tips, we can become more effective listeners and, in turn, help to bridge the divides that separate us.

Tuesday, February 6, 2024

Anthropomorphism in AI

Arleen Salles, Kathinka Evers & Michele Farisco
(2020) AJOB Neuroscience, 11:2, 88-95
DOI: 10.1080/21507740.2020.1740350

Abstract

AI research is growing rapidly raising various ethical issues related to safety, risks, and other effects widely discussed in the literature. We believe that in order to adequately address those issues and engage in a productive normative discussion it is necessary to examine key concepts and categories. One such category is anthropomorphism. It is a well-known fact that AI’s functionalities and innovations are often anthropomorphized (i.e., described and conceived as characterized by human traits). The general public’s anthropomorphic attitudes and some of their ethical consequences (particularly in the context of social robots and their interaction with humans) have been widely discussed in the literature. However, how anthropomorphism permeates AI research itself (i.e., in the very language of computer scientists, designers, and programmers), and what the epistemological and ethical consequences of this might be have received less attention. In this paper we explore this issue. We first set the methodological/theoretical stage, making a distinction between a normative and a conceptual approach to the issues. Next, after a brief analysis of anthropomorphism and its manifestations in the public, we explore its presence within AI research with a particular focus on brain-inspired AI. Finally, on the basis of our analysis, we identify some potential epistemological and ethical consequences of the use of anthropomorphic language and discourse within the AI research community, thus reinforcing the need of complementing the practical with a conceptual analysis.


Here are my thoughts:

Anthropomorphism is the tendency to attribute human characteristics to non-human things. In the context of AI, this means that we often ascribe human-like qualities to machines, such as emotions, intelligence, and even consciousness.

There are a number of reasons why we do this. One reason is that it helps us to make sense of the world around us. By understanding AI in terms of human qualities, we can more easily predict how it will behave and interact with us.

Another reason is that anthropomorphism can make AI more appealing and relatable. We are naturally drawn to things that we perceive as being similar to ourselves, and so we may be more likely to trust and interact with AI that we see as being somewhat human-like.

However, it is important to remember that AI is not human. It does not have emotions, feelings, or consciousness. Ascribing these qualities to AI can be dangerous, as it can lead to unrealistic expectations and misunderstandings.  For example, if we believe that an AI is capable of feeling emotions, we may be more likely to anthropomorphize it.

This can lead to problems, such as when the AI does not respond in a way that we expect. We may then attribute this to the AI being "sad" or "angry," when in reality it is simply following its programming.

It is also important to be aware of the ethical implications of anthropomorphizing AI. If we treat AI as if it were human, we may be more likely to give it rights and protections that it does not deserve. For example, we may believe that an AI should not be turned off, even if it is causing harm.

In conclusion, anthropomorphism is a natural human tendency, but it is important to be aware of the dangers of over-anthropomorphizing AI. We should remember that AI is not human, and we should treat it accordingly.

Monday, February 5, 2024

Should Patients Be Allowed to Die From Anorexia? Is a 'Palliative' Approach to Mental Illness Ethical?

Katie Engelhart
New York Times Magazine
Originally posted 3 Jan 24

Here is an excerpt:

He came to think that he had been impelled by a kind of professional hubris — a hubris particular to psychiatrists, who never seemed to acknowledge that some patients just could not get better. That psychiatry had actual therapeutic limits. Yager wanted to find a different path. In academic journals, he came across a small body of literature, mostly theoretical, on the idea of palliative psychiatry. The approach offered a way for him to be with patients without trying to make them better: to not abandon the people who couldn’t seem to be fixed. “I developed this phrase of ‘compassionate witnessing,’” he told me. “That’s what priests did. That’s what physicians did 150 years ago when they didn’t have any tools. They would just sit at the bedside and be with somebody.”

Yager believed that a certain kind of patient — maybe 1 or 2 percent of them — would benefit from entirely letting go of standard recovery-oriented care. Yager would want to know that such a patient had insight into her condition and her options. He would want to know that she had been in treatment in the past, not just once but several times. Still, he would not require her to have tried anything and everything before he brought her into palliative care. Even a very mentally ill person, he thought, was allowed to have ideas about what she could and could not tolerate.

If the patient had a comorbidity, like depression, Yager would want to know that it was being treated. Maybe, for some patients, treating their depression would be enough to let them keep fighting. But he wouldn’t insist that a person be depression-free before she left standard treatment. Not all depression can be cured, and many people are depressed and make decisions for themselves every day. It would be Yager’s job to tease out whether what the patient said she wanted was what she authentically desired, or was instead an expression of pathological despair. Or more: a suicidal yearning. Or something different: a cry for help. That was always part of the job: to root around for authenticity in the morass of a disease.


Some thoughts:

The question of whether patients with anorexia nervosa should be allowed to die from their illness or receive palliative care is a complex and emotionally charged one, lacking easy answers. It delves into the profound depths of autonomy, mental health, and the very meaning of life itself.

The Anorexic's Dilemma:

Anorexia nervosa is a severe eating disorder characterized by a relentless pursuit of thinness and an intense fear of weight gain. It often manifests in severe food restriction, excessive exercise, and distorted body image. This relentless control, however, comes at a devastating cost. Organ failure, malnutrition, and even death can be the tragic consequences of the disease's progression.

Palliative Care: Comfort Not Cure:

Palliative care focuses on symptom management and improving quality of life for individuals with life-threatening illnesses. In the context of anorexia, it would involve addressing physical discomfort, emotional distress, and spiritual concerns, but without actively aiming for weight gain or cure. This raises numerous ethical and practical questions:
  • Respecting Autonomy: Does respecting a patient's autonomy mean allowing them to choose a path that may lead to death, even if their decision is influenced by a mental illness?
  • The Line Between Choice and Coercion: How do we differentiate between a genuine desire for death and succumbing to the distorted thinking patterns of anorexia?
  • Futility vs. Hope: When is treatment considered futile, and when should hope for recovery, however slim, be prioritized?
Finding the Middle Ground:

There's no one-size-fits-all answer to this intricate dilemma. Each case demands individual consideration, taking into account the patient's mental capacity, level of understanding, and potential for recovery. Open communication, involving the patient, their family, and a multidisciplinary team of healthcare professionals, is crucial in navigating this sensitive terrain.

Potential Approaches:
  • Enhanced Supportive Care: Focusing on improving the patient's quality of life through pain management, emotional support, and addressing underlying psychological issues.
  • Conditional Palliative Care: Providing palliative care while continuing to offer and encourage life-sustaining treatment, with the possibility of transitioning back to active recovery if the patient shows signs of willingness.
  • Advance Directives: Encouraging patients to discuss their wishes and preferences beforehand, allowing for informed decision-making when faced with difficult choices.

Sunday, February 4, 2024

Psychoneuroimmunology: An Introduction to Immune-to-Brain Communication and Its Implications for Clinical Psychology

Julienne E. Bower and Kate R. Kuhlman
Annual Review of Clinical Psychology 2023 19:1, 331-359

Abstract

Research conducted over the past several decades has revolutionized our understanding of the role of the immune system in neural and psychological development and function across the life span. Our goal in this review is to introduce this dynamic area of research to a psychological audience and highlight its relevance for clinical psychology. We begin by introducing the basic physiology of immune-to-brain signaling and the neuroimmune network, focusing on inflammation. Drawing from preclinical and clinical research, we then examine effects of immune activation on key psychological domains, including positive and negative valence systems, social processes, cognition, and arousal (fatigue, sleep), as well as links with psychological disorders (depression, posttraumatic stress disorder, anxiety, schizophrenia). We also consider psychosocial stress as a critical modulator of neuroimmune activity and focus on early life adversity. Finally, we highlight psychosocial and mind–body interventions that influence the immune system and may promote neuroimmune resilience.


Here is a summary:

This research delves into the fascinating field of psychoneuroimmunology (PNI), exploring the intricate communication pathways between the brain, behavior, and immune system. It sheds light on how our mental and emotional states can influence our immune response, and vice versa, with profound implications for clinical psychology.

Key Insights:
  • Immune-to-brain communication: Inflammation, a crucial immune response, plays a central role in this dialogue. Immune cells release signaling molecules that reach the brain, impacting mood, cognition, and behavior.
  • Psychosocial stress and immunity: Stress acts as a potent modulator, amplifying inflammation and potentially leading to various physical and mental health issues like depression, anxiety, and even some neurodegenerative disorders.
  • Early life adversity and resilience: Early life experiences can leave lasting impressions on the neuroimmune system, influencing vulnerability or resilience to stress and disease later in life.
  • Implications for clinical psychology: Understanding PNI opens new avenues for intervention. Therapies targeting stress management, mindfulness, and social support could bolster neuroimmune resilience and improve mental health outcomes.
Future Directions:
  • Deciphering the complex mechanisms of immune-to-brain communication, particularly the role of specific molecules and brain regions.
  • Developing PNI-informed interventions for diverse clinical conditions, tailored to individual needs and vulnerabilities.
  • Integrating PNI knowledge into clinical training and practice to offer a more holistic understanding of mental health.

Saturday, February 3, 2024

How to Navigate the Pitfalls of AI Hype in Health Care

Suran M, Hswen Y.
JAMA.
Published online January 03, 2024.

What is AI snake oil, and how might it hinder progress within the medical field? What are the inherent risks in AI-driven automation for patient care, and how can we ensure the protection of sensitive patient information while maximizing its benefits?

When it comes to using AI in medicine, progress is important—but so is proceeding with caution, says Arvind Narayanan, PhD, a professor of computer science at Princeton University, where he directs the Center for Information Technology Policy.


Here is my summary:
  • AI has the potential to revolutionize healthcare, but it is important to be aware of the hype and potential pitfalls.
  • One of the biggest concerns is bias. AI algorithms can be biased based on the data they are trained on, which can lead to unfair or inaccurate results. For example, an AI algorithm that is trained on data from mostly white patients may be less accurate at diagnosing diseases in black patients.
  • Another concern is privacy. AI algorithms require large amounts of data to work, and this data can be very sensitive. It is important to make sure that patient data is protected and that patients have control over how their data is used.
  • It is also important to remember that AI is not a magic bullet. AI can be a valuable tool, but it is not a replacement for human judgment. Doctors and other healthcare professionals need to be able to critically evaluate the output of AI algorithms and make sure that it is being used in a safe and ethical way.
Overall, the interview is a cautionary tale about the potential dangers of AI in healthcare. It is important to be aware of the risks and to take steps to mitigate them. But it is also important to remember that AI has the potential to do a lot of good in healthcare. If we develop and use AI responsibly, it can help us to improve the quality of care for everyone.

Here are some additional points that were made in the interview:
  • AI can be used to help with a variety of tasks in healthcare, such as diagnosing diseases, developing new treatments, and managing chronic conditions.
  • There are a number of different types of AI, each with its own strengths and weaknesses.
  • It is important to choose the right type of AI for the task at hand.
  • AI should always be used in conjunction with human judgment.

Friday, February 2, 2024

Young people turning to AI therapist bots

Joe Tidy
BBC.com
Originally posted 4 Jan 24

Here is an excerpt:

Sam has been so surprised by the success of the bot that he is working on a post-graduate research project about the emerging trend of AI therapy and why it appeals to young people. Character.ai is dominated by users aged 16 to 30.

"So many people who've messaged me say they access it when their thoughts get hard, like at 2am when they can't really talk to any friends or a real therapist,"
Sam also guesses that the text format is one with which young people are most comfortable.
"Talking by text is potentially less daunting than picking up the phone or having a face-to-face conversation," he theorises.

Theresa Plewman is a professional psychotherapist and has tried out Psychologist. She says she is not surprised this type of therapy is popular with younger generations, but questions its effectiveness.

"The bot has a lot to say and quickly makes assumptions, like giving me advice about depression when I said I was feeling sad. That's not how a human would respond," she said.

Theresa says the bot fails to gather all the information a human would and is not a competent therapist. But she says its immediate and spontaneous nature might be useful to people who need help.
She says the number of people using the bot is worrying and could point to high levels of mental ill health and a lack of public resources.


Here are some important points-

Reasons for appeal:
  • Cost: Traditional therapy's expense and limited availability drive some towards bots, seen as cheaper and readily accessible.
  • Stigma: Stigma associated with mental health might make bots a less intimidating first step compared to human therapists.
  • Technology familiarity: Young people, comfortable with technology, find text-based interaction with bots familiar and less daunting than face-to-face sessions.
Concerns and considerations:
  • Bias: Bots trained on potentially biased data might offer inaccurate or harmful advice, reinforcing existing prejudices.
  • Qualifications: Lack of professional mental health credentials and oversight raises concerns about the quality of support provided.
  • Limitations: Bots aren't replacements for human therapists. Complex issues or severe cases require professional intervention.

Thursday, February 1, 2024

The death of the self in posttraumatic experience

Dorothy, J., & Hughes, E. (2023).
Philosophical Psychology, 1–21.

Abstract

Survivors of trauma commonly report feeling as though a part of themselves has died. This article provides a theoretical interpretation of this phenomenon, drawing on Waldenfels' notion of the split self. We argue that trauma gives rise to an explicit tension between the lived and corporeal body which is so profoundly distressing that it can be experienced by survivors as the death of part of oneself. We explore the ways in which this is manifest in the posttraumatic phenomena of dissociation; indescribability; and the fragmentation and repetition of time. Acknowledging that the traumatic loss of part of oneself involves significant grief, we then consider whether the bereavement literature might be helpfully applied. We focus specifically upon the continuing bonds model, which emphasizes an ongoing and meaningful relationship with the deceased through an active process of memorializing. In considering how this might be appropriated to the death of the self in trauma, we suggest that the development of an intrapersonal relationship between parts lost and living might, over time, offer a unique way in which to adapt to loss and approach the future.

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Here is my summary:

The article argues that the feeling of a "death of the self" commonly reported by trauma survivors isn't just a metaphor, but a profound rupture in their sense of being. Drawing on philosopher Bernhard Waldenfels' concept of the "split self," the authors explain how trauma can create a stark disconnect between the lived experience of the body and the pre-trauma sense of self. This can manifest in dissociative symptoms, feelings of unreality, and disruptions in one's understanding of time. They argue that this "death of the self" lies at the core of several posttraumatic stress disorder (PTSD) symptoms, particularly the tension between hyperarousal and detachment. The article ultimately suggests that recognizing this experience of self-death could be crucial for developing more effective trauma interventions.

Here are some additional key points:
  • The article emphasizes the subjective and embodied nature of trauma, rather than viewing it solely as a psychological event.
  • It highlights the importance of understanding the complexities of dissociation in trauma survivors.
  • The article challenges traditional notions of PTSD by suggesting that self-death might be a more accurate description of the central trauma experience.
  • It offers therapeutic implications for treating trauma by focusing on integrating the fragmented pieces of the self.
Our moral self, the set of deeply held values and beliefs that guide our actions and judgments, lays the foundation for our lived experience. It shapes how we make sense of the world, navigate relationships, and interact with others. This moral compass provides a sense of coherence and belonging, anchoring us in a broader community of shared values.

However, when we experience trauma, this foundation can be severely shaken. Traumatic events, especially those that violate our core values or sense of justice, can shatter the very beliefs that once structured our lives. This can lead to a fracturing of the moral self.

Despite the profound rupture trauma can cause, the human capacity for healing and growth is remarkable. Even from the ashes of fractured morality, post-traumatic growth can emerge. This process involves integrating the fragmented pieces of the moral self with an expanded understanding of oneself and the world.