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

Monday, July 1, 2024

Effects of intellectual humility in the context of affective polarization: Approaching and avoiding others in controversial political discussions

Knöchelmann, L., & Cohrs, J. C. (2024).
Journal of personality and social psychology, 
10.1037/pspi0000462.
Advance online publication.

Abstract

Affective polarization, the extent to which political actors treat each other as disliked outgroups, is challenging political exchange and deliberation, for example, via mistrust of the "political enemy" and unwillingness to discuss political topics with them. The present experiments address this problem and study what makes people approach, and not avoid, potential discussion partners in the context of polarized political topics in Germany. We hypothesized that intellectual humility, the recognition of one's intellectual limitations, would predict both less affective polarization and higher approach and lower avoidance tendencies toward contrary-minded others. Across four preregistered online-survey experiments (N = 1,668), we manipulated how intellectually humble a target person was perceived and measured participants' self-reported (topic-specific) intellectual humility. Results revealed that participants' intellectual humility was consistently negatively correlated with affective polarization. Additionally, intellectual humility of both the target person and the participants was beneficial, and sometimes even necessary, to make participants approach, and not avoid, the target person. Intellectual humility was more important than moral conviction, opinion, and opinion strength. Furthermore, the effects on approach and avoidance were mediated by more positive expectations regarding the debate, and the effects on future willingness for contact by higher target liking. Our findings suggest that intellectual humility is an important characteristic to enable political exchange as it leads to seeing political outgroups more positively and to a higher willingness to engage in intergroup contact. Implications for intergroup contact of political groups as well as ideas for future research are discussed.


Here are some thoughts as to why intellectual humility is important to practicing psychologists:

Intellectual humility involves recognizing the limits of one's knowledge and being open to opposing perspectives.  This can help therapists avoid being overly dogmatic or dismissive of their clients' beliefs, even if they disagree. Maintaining an open and non-judgmental stance is crucial for building a strong therapeutic alliance.

People higher in intellectual humility tend to be more empathetic, forgiving, and valuing of others' wellbeing.  These qualities can facilitate better rapport and understanding between therapists and clients from different backgrounds or with contrasting worldviews.

Intellectual humility is associated with reduced polarization, extremism, and susceptibility to conspiracy beliefs.  Therapists exhibiting intellectual humility can model these qualities for clients struggling with rigid ideological stances that strain their relationships.

When political or controversial topics arise in therapy, intellectual humility can allow therapists to thoughtfully consider different perspectives without getting mired in unproductive debates or power struggles with clients.  An intellectually humble stance creates space for productive dialogue.

Overall, cultivating intellectual humility may help therapists navigate affective polarization and controversial topics more constructively in the therapeutic context by increasing openness, empathy, and willingness to entertain alternative viewpoints.  This can strengthen the therapeutic relationship and facilitate progress, even when working with clients holding contrasting beliefs.

Sunday, June 30, 2024

Reddit Provides Insight into How People Think About Moral Dilemmas

Sigal Samuel
Vox: Future Perfect
Undated post

Here is a sample:

Uncovering philosophy’s blind spots 

Let’s get a bit more precise: It’s not as though all of philosophy has ignored relational context. But one branch — utilitarianism — is strongly inclined in this direction. Utilitarians believe we should seek the greatest happiness for the greatest number of people — and we have to consider everybody’s happiness equally. So we’re not supposed to be partial to our own friends or family members. 

This ethical approach took off in the 18th century. Today, it’s extremely influential in Western philosophy — and not just in the halls of academia. Famous philosophers like Peter Singer have popularized it in the public sphere, too. 

Increasingly, though, some are challenging it. 

“Moral philosophy has for so long been about trying to identify universal moral principles that apply to all people regardless of their identity,” Yudkin told me. “And it’s because of this effort that moral philosophers have really moved away from the relational perspective. But the more that I think about the data, the more clear to me it is that you’re losing something essential from the moral equation when you abstract away from relationships.” 

Moral psychologists like Princeton’s Molly Crockett and Yale’s Margaret Clark have likewise been investigating the idea that moral obligations are relationship-specific.

“Here’s a classic example,” Crockett told me a few years ago. “Consider a woman, Wendy, who could easily provide a meal to a young child but fails to do so. Has Wendy done anything wrong? It depends on who the child is. If she’s failing to provide a meal to her own child, then absolutely she’s done something wrong! But if Wendy is a restaurant owner and the child is not otherwise starving, then they don’t have a relationship that creates special obligations prompting her to feed the child.”

According to Crockett, being a moral agent has become trickier for us with the rise of globalization, which forces us to think about how our actions might affect people we’re never going to meet. “Being a good global citizen now butts up against our very powerful psychological tendencies to prioritize our families and friends,” Crockett told me.


Here is my summary:

Reddit Provides Insight into How People Think About Moral Dilemmas
  • Philosophers Daniel Yudkin and colleagues analyzed millions of comments from Reddit's "Am I the Asshole?" forum to study how ordinary people reason about moral dilemmas in real life situations.
  • They found the most common dilemmas involved "relational obligations" - what we owe to others based on our relationships with them, like family, friends, coworkers etc.
  • The types of moral dilemmas people faced varied based on the specific relationship context (e.g. with a sibling vs. manager).
Challenging the Impartiality of Utilitarianism
  • This challenges the utilitarian view in philosophy that we should impartially maximize happiness for everyone equally, ignoring special relationships.
  • Some argue this impartial view overlooks the deep psychological importance of prioritizing close relations like family over strangers.
  • While impartiality may be an ideal, critics say it is psychologically unrealistic to expect people to abandon loved ones to help larger numbers of strangers.
  • The research highlights how modern moral philosophy, especially utilitarianism, may fail to account for the central role relationships and social contexts play in ordinary moral reasoning and obligations.
As others have said better than me, moral norms and principles provide a shared framework for evaluating right and wrong behavior. They define obligations and duties we have towards others, especially those close to us. By adhering to moral codes, individuals can build trust, reciprocity, and a sense of fairness in their relationships.

The expression of moral judgments, both positive and negative, helps regulate self-interest and enforce cooperative norms within groups. When people can call out immoral actions and praise ethical conduct, it incentivizes prosocial behavior and discourages free-riding. This promotes cooperation for mutual benefit.

Saturday, June 29, 2024

OpenAI insiders are demanding a “right to warn” the public

Sigal Samuel
Vox.com
Originally posted 5 June 24

Here is an excerpt:

To be clear, the signatories are not saying they should be free to divulge intellectual property or trade secrets, but as long as they protect those, they want to be able to raise concerns about risks. To ensure whistleblowers are protected, they want the companies to set up an anonymous process by which employees can report their concerns “to the company’s board, to regulators, and to an appropriate independent organization with relevant expertise.” 

An OpenAI spokesperson told Vox that current and former employees already have forums to raise their thoughts through leadership office hours, Q&A sessions with the board, and an anonymous integrity hotline.

“Ordinary whistleblower protections [that exist under the law] are insufficient because they focus on illegal activity, whereas many of the risks we are concerned about are not yet regulated,” the signatories write in the proposal. They have retained a pro bono lawyer, Lawrence Lessig, who previously advised Facebook whistleblower Frances Haugen and whom the New Yorker once described as “the most important thinker on intellectual property in the Internet era.”


Here are some thoughts:

AI development is booming, but with great power comes great responsibility, typed the Spiderman fan.  AI researchers at OpenAI are calling for a "right to warn" the public about potential risks. In clinical psychology, we have a "duty to warn" for violent patients. This raises important ethical questions. On one hand, transparency and open communication are crucial for responsible AI development.  On the other hand, companies need to protect their ideas.  The key seems to lie in striking a balance.  Researchers should have safe spaces to voice concerns without fearing punishment, and clear guidelines can help ensure responsible disclosure without compromising confidential information.

Ultimately, fostering a culture of open communication is essential to ensure AI benefits society without creating unforeseen risks.  AI developers need similar ethical guidelines to psychologists in this matter.

Friday, June 28, 2024

Becoming a culturally responsive and socially just clinical supervisor

Spowart, J. K. P., & Robertson, S. E. (2024).
Canadian Psychology / Psychologie canadienne.
Advance online publication. 
https://doi.org/10.1037/cap0000388

Abstract

Clinical supervisors must learn to attend to and address a breadth of cultural, diversity and social justice factors and dynamics when providing supervision. Developing these abilities does not occur automatically; rather, training in clinical supervision has a significant impact on supervisors’ development. Unfortunately, there is relatively limited research on how supervisors develop these same ways of being and working. Therefore, the purpose of this study was to explore how counselling psychology doctoral students understand their experiences of becoming culturally responsive and socially just clinical supervisors. Findings from this study detail the developmental experiences of novice supervisors and highlight training needs, educational interventions, progression of competencies and experiences with counselling supervisees and supervisors-of-supervision. Implications for theories of supervisor development and approaches in graduate training programmes are discussed along side of calls to more robustly integrate culturally responsive and socially just training and approaches throughout the field of clinical supervision.

Impact Statement

Clinical supervisors are responsible for attending to and addressing issues of culture, diversity and advocacy so that they may better prepare new mental health practitioners to support populations from diverse backgrounds. Little is known about the training experiences and needs of clinical supervisors as they learn to carry out this important work. The present study addresses this gap in the literature by highlighting the experiences of supervisors-in-training and provides tangible education and training recommendations to help ensure more culturally responsive and socially just clinical supervision practices.

Here are two excerpts:

From the Introduction:

Clinical supervision is a distinct area of practice in psychology (Arthur & Collins, 2015). Historically, it was assumed that becoming a clinical supervisor was "a natural outgrowth of the acquisition of [counselling] experience" (Thériault & Gazzola, 2019, p. 155). Currently, it is recognised that becoming a clinical supervisor is a unique, complex and multifaceted developmental process in which distinct skills, knowledge, awareness and attitudes must be cultivated (Falender & Shafranske, 2017; Thériault & Gazzola, 2019). Adding to this, providing supervision alone does not guarantee supervisor development or the acquisition of clinical supervision competencies (Falender & Shafranske, 2004; C. E. Watkins, 2012). Rather, training in clinical supervision has been shown to have a significant impact on development as a supervisor (Christofferson et al., 2023; Gazzola & De Stefano, 2016; Milne et al., 2011). Individuals may obtain such training either during graduate school or through postgraduate professional development.

From the Discussion:

To begin, the importance of MCSJ (Multicultural Social Justice) factors and dynamics served as a context for the doctoral student SITs' (Supervisors In Training) experiences. As if it were a lens through which they understood their practice and development, their focus on MCSJ factors and dynamics was not something that could be divorced from their experiences. As they were transitioning into and taking on their new role, the SITS experienced some initial difficulties. At first, they felt they needed a road map. They did not have a clear understanding of how they could provide CRSJ supervision and wished they had received more initial guidance. Some of these initial difficulties abated as the doctoral student SITS were impacted by a number of supports to their development.

Thursday, June 27, 2024

When Therapists Lose Their Licenses, Some Turn to the Unregulated Life Coaching Industry Instead

Jessica Miller
Salt Lake Tribune
Originally published 17 June 24

A frustrated woman recently called the Utah official in charge of professional licensing, upset that his office couldn’t take action against a life coach she had seen. Mark Steinagel recalls the woman telling him: “I really think that we should be regulating life coaching. Because this person did a lot of damage to me.”

Reports about life coaches — who sell the promise of helping people achieve their personal or professional goals — come into Utah’s Division of Professional Licensing about once a month. But much of the time, Steinagel or his staff have to explain that there’s nothing they can do.

If the woman had been complaining about any of the therapist professions overseen by DOPL, Steinagel’s office might have been able to investigate and potentially order discipline, including fines.

But life coaches aren’t therapists and are mostly unregulated across the United States. They aren’t required to be trained in ethical boundaries the way therapists are, and there’s no universally accepted certification for those who work in the industry.


Here are some thoughts on the ethics of this trend:

The trend of therapists who have lost their licenses transitioning to the unregulated life coaching industry raises significant ethical concerns and risks. This shift allows individuals who have been deemed unfit to practice therapy to continue working with vulnerable clients without oversight or accountability. The lack of regulation in life coaching means that these practitioners can potentially continue harmful behaviors, misrepresent their qualifications, and exploit clients without facing the same consequences they would in the regulated therapy field.

This situation poses substantial risks to clients (and the integrity of coaching as profession). Clients seeking help may not understand the difference between regulated therapy and unregulated life coaching, potentially exposing themselves to practitioners who have previously violated ethical standards. The presence of discredited therapists in the life coaching industry can erode public trust in mental health services and coaching alike, potentially deterring individuals from seeking necessary help. Moreover, clients have limited legal recourse if they are harmed by an unregulated life coach, leaving them vulnerable to financial and emotional distress.

To address these concerns, there is a pressing need for regulatory measures in the life coaching industry, particularly concerning practitioners with a history of ethical violations in related fields. Such regulations could help maintain the integrity of coaching, protect vulnerable clients, and ensure that those seeking help receive services from qualified and ethical practitioners. Without such measures, the potential for harm remains significant, undermining the valuable work done by ethical professionals in both therapy and life coaching.

Wednesday, June 26, 2024

Can Generative AI improve social science?

Bail, C. A. (2024).
Proceedings of the National Academy of
Sciences of the United States of America, 121(21). 

Abstract

Generative AI that can produce realistic text, images, and other human-like outputs is currently transforming many different industries. Yet it is not yet known how such tools might influence social science research. I argue Generative AI has the potential to improve survey research, online experiments, automated content analyses, agent-based models, and other techniques commonly used to study human behavior. In the second section of this article, I discuss the many limitations of Generative AI. I examine how bias in the data used to train these tools can negatively impact social science research—as well as a range of other challenges related to ethics, replication, environmental impact, and the proliferation of low-quality research. I conclude by arguing that social scientists can address many of these limitations by creating open-source infrastructure for research on human behavior. Such infrastructure is not only necessary to ensure broad access to high-quality research tools, I argue, but also because the progress of AI will require deeper understanding of the social forces that guide human behavior.

Here is a brief summary:

Generative AI, with its ability to produce realistic text, images, and data, has the potential to significantly impact social science research.  This article explores both the exciting possibilities and potential pitfalls of this new technology.

On the positive side, generative AI could streamline data collection and analysis, making social science research more efficient and allowing researchers to explore new avenues. For example, AI-powered surveys could be more engaging and lead to higher response rates. Additionally, AI could automate tasks like content analysis, freeing up researchers to focus on interpretation and theory building.

However, there are also ethical considerations. AI models can inherit and amplify biases present in the data they're trained on. This could lead to skewed research findings that perpetuate social inequalities. Furthermore, the opaqueness of some AI models can make it difficult to understand how they arrive at their conclusions, raising concerns about transparency and replicability in research.

Overall, generative AI offers a powerful tool for social scientists, but it's crucial to be mindful of the ethical implications and limitations of this technology. Careful development and application are essential to ensure that AI enhances, rather than hinders, our understanding of human behavior.

Tuesday, June 25, 2024

‘I’m dying, you’re not': Those terminally ill ask more states to legalize physician-assisted death

Jesse Bedayn
AP
Updated 6:39 PM EDT, April 12, 2024

On a brisk day at a restaurant outside Chicago, Deb Robertson sat with her teenage grandson to talk about her death.

She’ll probably miss his high school graduation. She declined the extended warranty on her car. Sometimes she wonders who will be at her funeral.

Those things don’t frighten her much. The 65-year-old didn’t cry when she learned two months ago that the cancerous tumors in her liver were spreading, portending a tormented death.

But later, she received a call. A bill moving through the Illinois Legislature to allow certain terminally ill patients to end their own lives with a doctor’s help had made progress.

Then she cried.

“Medical-aid in dying is not me choosing to die,” she says she told her 17-year-old grandson. “I am going to die. But it is my way of having a little bit more control over what it looks like in the end.”


Here is a summary:

The article discusses the ethical and moral debate surrounding physician-assisted death (PAD), also known as medical aid in dying (MAiD). It highlights the desire of terminally ill patients for more control over their end-of-life experience, including the option for a peaceful death facilitated by a doctor.

On one hand, the article presents the perspective of patients like Deb Robertson, who argues that MAiD isn't about choosing to die, but about choosing how to die with dignity on their own terms, avoiding prolonged suffering.

On the other hand, the patchwork of laws across different states raises ethical concerns.  Some states are considering legalizing MAiD, while others are proposing stricter bans. This creates a situation where some patients have to travel to distant states or forgo their wishes entirely.

The article doesn't take a definitive stance on the morality of MAiD, but rather presents the arguments on both sides, leaving the reader to consider the complex ethical questions surrounding end-of-life decisions.

Monday, June 24, 2024

Evidence-Based Care for Suicidality as an Ethical & Professional Imperative: How to Decrease Suicidal Suffering & Save Lives

Jobes, D. A., & Barnett, J. E. (2024).
The American Psychologist
10.1037/amp0001325.
Advance online publication.

Abstract

Suicide is a major public and mental health problem in the United States and around the world. According to recent survey research, there were 16,600,000 American adults and adolescents in 2022 who reported having serious thoughts of suicide (Substance Abuse and Mental Health Services Administration, 2023), which underscores a profound need for effective clinical care for people who are suicidal. Yet there is evidence that clinical providers may avoid patients who are suicidal (out of fear and perceived concerns about malpractice liability) and that too many rely on interventions (i.e., inpatient hospitalization and medications) that have little to no evidence for decreasing suicidal ideation and behavior (and may even increase risk). Fortunately, there is an emerging and robust evidence-based clinical literature on suicide-related assessment, acute clinical stabilization, and the actual treatment of suicide risk through psychological interventions supported by replicated randomized controlled trials. Considering the pervasiveness of suicidality, the life versus death implications, and the availability of proven approaches, it is argued that providers should embrace evidence-based practices for suicidal risk as their best possible risk management strategy. Such an embrace is entirely consistent with expert recommendations as well as professional and ethical standards. Finally, a call to action is made with a series of specific recommendations to help psychologists (and other disciplines) use evidence-based, suicide-specific, approaches to help decrease suicide-related suffering and deaths. It is argued that doing so has now become both an ethical and professional imperative. Given the challenge of this issue, it is also simply the right thing to do. 

Note: I really wish the APA would make these article available for every mental health provider.

Here is my best summary:
  1. Use evidence-based suicide risk assessments like the Ask Suicide Questionnaire, Columbia Suicide Severity Rating Scale, and Patient Health Questionnaire-9 to identify suicide risk, but do not rely solely on them.
  2. Implement acute stabilization interventions for highly suicidal patients, such as the Safety Plan Intervention, Crisis Response Plan, reducing access to lethal means, crisis hotlines/text lines, and caring contact follow-ups.
  3. Utilize evidence-based psychological treatments focused specifically on suicidal thoughts and behaviors, rather than solely treating underlying mental disorders. Examples are Cognitive Therapy for Suicide Prevention, Dialectical Behavior Therapy, and the Collaborative Assessment and Management of Suicidality.
  4. Receive comprehensive training in evidence-based suicide assessment and treatment during education and through continuing education to increase competence and reduce fear of working with suicidal patients.
  5. Integrate significant others into treatment with patient consent for support, monitoring, and reducing hospitalization need, while addressing confidentiality.
  6. Follow risk management strategies like thorough informed consent, documentation, and consulting colleagues, which align with ethical principles and reduce liability concerns.

Sunday, June 23, 2024

Healthcare Needs Qualified Expert Witnesses More Than Ever

Baum, N., MD. (2024, May 15).
MedPage Today
Originally posted 15 May 24

Any physician or scientist who has served as an expert witness is no doubt familiar with the three golden rules of testifying in a civil or criminal trial: 1) Do unto others as you would have them do unto you. 2) Them that's got the gold, rules. 3) The lawyer with the best medical expert gets the gold.

Rule Three becomes more salient as the need for medical and scientific expert witnesses is likely to accelerate due to an explosion of jury awards. In the decade from 2013 to 2023, malpractice verdicts of $10 million or more grew by 67%, according to reinsurance company TransRe. Enormous malpractice awards like these are clearly on the rise.

In 2023, several massive payouts made splashy headlines. For example, in November, a Florida jury ordered Johns Hopkins All Children's Hospital in St. Petersburg to pay a whopping $261 million for alleged medical negligence and false imprisonment of a young girl.

The case inspired the Netflix documentary "Take Care of Maya" which chronicled events leading to the suicide of Maya Kowalski's mother over Maya's separation from her family during months of hospitalization.

Also in 2023, a Pennsylvania jury ordered the Hospital of the University of Pennsylvania to pay $183 million for an alleged birth gone wrong, resulting in cerebral palsy and substantial neurodevelopmental delays. And in New York, a jury awarded $120 million to a stroke victim for alleged delayed diagnosis and treatment leading to extensive brain damage.


Here are some thoughts:

The article raises a crucial point about the need for qualified expert witnesses in healthcare-related legal cases. The complexities of the healthcare system demand a deep understanding of medical practices, procedures, and the intricate web of regulations that govern the industry. Unqualified or ill-informed expert testimony can have severe consequences, potentially leading to miscarriages of justice and undermining public trust in the healthcare system. It is imperative that expert witnesses possess the necessary credentials, experience, and up-to-date knowledge to provide accurate and impartial assessments.

Furthermore, the ethical implications of expert witness testimony in healthcare cases cannot be overstated. Healthcare professionals are bound by strict ethical codes that prioritize patient well-being, informed consent, and the preservation of human dignity. Expert witnesses must uphold these ethical principles and ensure that their testimony aligns with the highest standards of professional conduct. They must resist any temptation to skew their opinions or present biased information, as doing so could compromise the integrity of the legal process and potentially harm patients or healthcare providers.