A Code of Ethics for Health Care Ethics Consultants

Anita J. Tarzian & Lucia D. Wocial
American Journal of Bioethics 15 (5):38-51 (2015)

Abstract

For decades a debate has played out in the literature about who bioethicists are, what they do, whether they can be considered professionals qua bioethicists, and, if so, what professional responsibilities they are called to uphold. Health care ethics consultants are bioethicists who work in health care settings. They have been seeking guidance documents that speak to their special relationships/duties toward those they serve. By approving a Code of Ethics and Professional Responsibilities for Health Care Ethics Consultants, the American Society for Bioethics and Humanities (ASBH) has moved the professionalization debate forward in a significant way. This first code of ethics focuses on individuals who provide health care ethics consultation (HCEC) in clinical settings. The evolution of the code's development, implications for the field of HCEC and bioethics, and considerations for future directions are presented here.

The entire paper is here.

The Funny Thing About Adversity

By David DeSteno
The New York Times
Originally published October 16, 2015

Here are several excerpts:

In both studies, the results were the same. Those who had faced increasingly severe adversities in life — loss of a loved one at an early age, threats of violence or the consequences of a natural disaster — were more likely to empathize with others in distress, and, as a result, feel more compassion for them. And of utmost importance, the more compassion they felt, the more money they donated (in the first study) or the more time they devoted to helping the other complete his work (in the second).

Now, if experiencing any type of hardship can make a person more compassionate, you might assume that the pinnacle of compassion would be reached when someone has experienced the exact trial or misfortune that another person is facing. Interestingly, this turns out to be dead wrong.

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As a result of this glitch, reflecting on your own past experience with a specific misfortune will very likely cause you to under appreciate just how trying that exact challenge can be for someone else (or was, in fact, for you at the time). You overcame it, you think; so should he. The result? You lack compassion.

The entire article is here.

Psychological principles could explain major healthcare failings

Press Release
Bangor University
Originally released on

Here is an excerpt:

In the research paper, Dr Michelle Rydon-Grange who has just qualified as a Clinical Psychologist at the School of Psychology, applies psychological theory to find new understandings of the causes that lead to catastrophic failures in healthcare settings.  She explains that the aspect often neglected in inquiries is the role that human behaviour plays in contributing to these failures, and hopes that using psychological theories could prevent their reoccurrence in the future.

The value of psychological theory in safety-critical industries such as aviation and nuclear power has long been acknowledged and is based upon the notion that certain employee behaviours are required to maintain safety. However, the same is not yet true of healthcare.

Though there may not be obvious similarities between various healthcare scandals which have occurred in disparate areas of medicine over the last few decades, striking similarities in the conditions under which these crises occurred can be found, according to Rydon-Grange.

The entire pressor is here.

Only two sexes?

By Sarah Graham
The Independent
Originally posted October 17, 2015

Here is an excerpt:

It’s not surprising so many people are ignorant about us intersex people: Our very existence has been erased since the Roman Empire. It continued in the 20th century, as doctors got their scalpels out to “normalise” our bodies. In the last fifteen years, since some of us started finding our dissident voices and protesting, doctors have tried to rebrand us and said we have “Disorders of Sexual Development (DSDs)” - to legitimize their paternalism and on-going annihilation of our beings.

This is all to keep you - the public - in the dark. And to rigidly enforce the pink and blue boxes: the boring binary, straight-laced order. But let me bring you up-to-speed. There are not only the two sexes of male and female. This is an absolute barefaced lie. Nature produces bodies on a spectrum; a continuum of possibilities.

You have met one of us somewhere, for sure. As many as 1 in 1,500 babies is born visibly intersex, while many more are born not so obviously unique and interesting to the eye.

The entire article is here.

The neuroscience of moral cognition: from dual processes to dynamic systems

Jay J Van Bavel, Oriel FeldmanHall, Peter Mende-Siedlecki
Current Opinion in Psychology
Volume 6, December 2015, Pages 167–172

Prominent theories of morality have integrated philosophy with psychology and biology. Although this approach has been highly generative, we argue that it does not fully capture the rich and dynamic nature of moral cognition. We review research from the dual-process tradition, in which moral intuitions are automatically elicited and reasoning is subsequently deployed to correct these initial intuitions. We then describe how the computations underlying moral cognition are diverse and widely distributed throughout the brain. Finally, we illustrate how social context modulates these computations, recruiting different systems for real (vs. hypothetical) moral judgments, examining the dynamic process by which moral judgments are updated. In sum, we advocate for a shift from dual-process to dynamic system models of moral cognition.

The entire article is here.

Are MBAs to blame for VW and other business ethics fiascos?

By  Ethan Baron
Forbes
Originally published October 22, 2015

Here is an excerpt:

So, what’s wrong with recent business people today? In an interview, Queen points to an over-emphasis on tolerance, that makes it very difficult for many people to even say something is wrong. Students are entering business schools “almost as kind of blank slates in terms of [their] ability to think about, to argue about, the good,” Queen says. “Even if they may have a business ethics class, that’s not reinforced by the other messages they’re getting either in the school, from their peers, perhaps even from the business world as a whole.”

While Queen sees what may be the start of a shift away from this line of thinking, he believes that in B-schools, students are generally still coming away with a belief that a return on investment trumps all other values. And within business programs, that ideology makes it difficult for students to swim against the current. Taking an alternate view can lead students to feel alone and alienated.

The entire article is here.

Many Antidepressant Studies Found Tainted by Pharma Company Influence

By Roni Jacobson
Scientific American
Originally published October 21, 2015

Here is an excerpt:

Almost 80 percent of meta-analyses in the review had some sort of industry tie, either through sponsorship, which the authors defined as direct industry funding of the study, or conflicts of interest, defined as any situation in which one or more authors were either industry employees or independent researchers receiving any type of industry support (including speaking fees and research grants). Especially troubling, the study showed about 7 percent of researchers had undisclosed conflicts of interest. “There’s a certain pecking order of papers,” says Erick Turner, a professor of psychiatry at Oregon Health & Science University who was not associated with the research. “Meta-analyses are at the top of the evidence pyramid.” Turner was “very concerned” by the results but did not find them surprising. “Industry influence is just massive. What’s really new is the level of attention people are now paying to it.”

The researchers considered all meta-analyses of randomized controlled trials for all approved antidepressants including selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, atypical antidepressants, monoamine oxidase inhibitors and others published between 2007 and March 2014.

The entire article is here.

Does Disbelief in Free Will Increase Anti-Social Behavior?

By Gregg Caruso
Psychology Today Blog
Originally published October 16, 2015

Here is an excerpt:

Rather than defend free will skepticism, however, I would like to examine an important practical question: What if we came to disbelieve in free will and basic desert moral responsibility? What would this mean for our interpersonal relationships, society, morality, meaning, and the law? What would it do to our standing as human beings? Would it cause nihilism and despair as some maintain? Or perhaps increase anti-social behavior as some recent studies have suggested (more of this in a moment)? Or would it rather have a humanizing effect on our practices and policies, freeing us from the negative effects of free will belief? These questions are of profound pragmatic importance and should be of interest independent of the metaphysical debate over free will. As public proclamations of skepticism continue to rise, and as the media continues to run headlines proclaiming that free will is an illusion, we need to ask what effects this will have on the general public and what the responsibility is of professionals.

In recent years a small industry has actually grown up around precisely these questions. In the skeptical community, for example, a number of different positions have been developed and advanced—including Saul Smilansky’s illusionism, Thomas Nadelhoffer’s disillusionism, Shaun Nichols’ anti-revolution, and the optimistic skepticism of Derk Pereboom, Bruce Waller, and myself.

The entire article is here.

The Illusion of Choice: Free Will and Determinism

By Vexen Crabtree
Science and Truth Versus Mass Confusion

1. Nothing Escapes the Laws of Physics

Free will is an illusion. Our amazingly, wonderfully complex brains are comprised of various cognitive systems cycling amongst themselves and generating our thoughts, consciousness, choices and behaviour. These systems and their effects all result from the mechanical, inorganic laws of physics, over which we have no control.

Consciousness is presented to us as a result of our neurons, our brains, our senses. When we lose these, we lose consciousness. These systems are governed and controlled by neurochemicals, hormones, ionisation, impulses: in short, by biochemistry. Biochemistry is in turn merely a type of chemistry, and when we look at the molecules and atoms that make up our chemistry, they obey the laws of physics.

Balls bouncing around a pool table have no free will. The basic chemicals that make up our bodies and minds have no free will. Neurons fire when they should fire, according to their electrochemical properties. They don't randomly fire: They fire when they're stimulated to fire by other neurons or by environmental inputs. Stimulation results from a constant biochemical cycle. These natural cycles determine our states of mind and our choices. Through a long and complicated series of cause and effect, our choices are made. As such, all our 'choices' are ultimately the result of impersonal and mechanical forces. There is no "free will force" that causes neurons to fire some times and not at others. They fire in accordance with the rules of physics, firmly beyond our control but not beyond our appreciation. These facts are proclaimed also by none other than the foremost physicist Albert Einstein:

“I do not at all believe in human freedom in the philosophical sense. Everybody acts not only under external compulsion but also in accordance with inner necessity.”
Albert Einstein (1954)

Sociologists and psychologists have studied the subliminal, subconscious and external factors that affect our behaviour, and a vast number of studies that have found that our behaviour is determined by outside agency but that we always think it is caused by our own will.

The entire blog entry is here.

Why the Free Will Debate Never Ends

By Julian Baggini
The Philosophers Magazine
Originally published October 13, 2015

Here is an excerpt:

Smilansky is speculating about optimism and pessimism. But one study has come up with some empirical evidence that extraversion and introversion are correlated with beliefs about free will, concluding that “extraversion predicts, to a significant extent, those who have compatibilist versus incompatibilist intuitions.”

Many are appalled by this idea as it goes against the whole notion that philosophy is about arguments, not arguers. But you only need to read the biographies and autobiographies of great philosophers to see that their personalities are intimately tied up with their ideas. W V O Quine, for instance, recalled how as a toddler he sought the unfamiliar way home, which he interpreted as reflecting “the thrill of discovery in theoretical science: the reduction of the unfamiliar to the familiar.” Later, he was obsessed with crossing state lines and national borders, ticking each off on a list as he did so. Paul Feyerabend recalled how, not yet ten, he was enchanted by magic and mystery and wasn’t affected by “the many strange events that seemed to make up our world.” Only a philosopher with delusions of her subject's objectivity would be surprised to find out that Quine and Feyerabend went on to write very different kinds of philosophy: Quine’s in a formal, logical, systematising tradition (though typically on the limits of such formalisations); Feyerabend’s anti-reductive and anti-systematising. It would take a great deal of faith in the objectivity of philosophy and philosophers to think that Feyerabend and Quine arrived at their respective philosophical positions simply by following the arguments where they led, when their inclinations so obviously seem to be in tune with their settled conclusions.

The entire article is here.

A Short History of Empathy

By Susan Lanzoni
The Atlantic
Originally published October 15, 2015

Here is an excerpt:

In the past few decades, interest in empathy has spread beyond psychology to primatology and neuroscience. In the 1990s, neuroscientists studying monkeys discovered mirror neurons, cells in the animals’ brains that fired not only when a monkey moved, but also when the monkey saw another one make the same movement. The discovery of mirror neurons spurred a wave of research into empathy and brain activity that quickly extended to humans as well. Other recent studies have further widened empathy’s reach into fields like economics and literature, finding that wealth disparities weaken empathic response and that reading fiction can improve it.

But as Kristof and Bloom illustrate, there is still some cultural debate about what empathy means today. And in the psychology community, the answers are no more clear-cut. Critics of the mirror-neuron theory, for example, question not only the location of these neurons in the human brain, but whether simulation of another’s gestures is a good description of empathy in the first place. The social psychologist C. Daniel Batson, who has researched empathy for decades, argues that the term can now refer to eight different concepts: knowing another’s thoughts and feelings; imagining another’s thoughts and feelings; adopting the posture of another; actually feeling as another does; imagining how one would feel or think in another’s place; feeling distress at another’s suffering; feeling for another’s suffering, sometimes called pity or compassion; and projecting oneself into another’s situation.

The entire article is here.

Microaggression, macro harm

By Regina Rini
The Los Angeles Times
Originally published on October 15, 2015

Here is an excerpt:

There is a serious problem with Campbell and Manning's moral history, and exposing it helps us see that the culture of victimhood label is misleading. Their history is a history of the dominant moral culture: It describes the mores of those social groups with the greatest access to power. Think about the culture of honor and notice how limited it must have been. If you were a woman in medieval Europe, you were not expected or permitted to respond to insults with aggression. Even if you were a lower-class man, you certainly would not have drawn your sword in response to an insult from a superior.

Now think about the culture of dignity, which Campbell and Manning claim “existed perhaps in its purest form among respectable people in the homogenous towns of mid-20th century America.” Another thing that existed among the “respectable people” in those towns was approval of racial segregation; “homogenous towns” did not arise by accident.

People of color, women, gay people, immigrants: none could rely on the authorities to respond fairly to reports of mistreatment.

The cultures of honor and dignity left many types of people with no recognized way of responding to moral mistreatment.

The entire article is here.

Choosing Empathy

A Conversation with Jamil Zaki
The Edge
Originally published October 19, 2015

Here are some excerpts:

The first narrative is that empathy is automatic. This goes all the way back to Adam Smith, who, to me, generated the first modern account of empathy in his beautiful book, The Theory of Moral Sentiments. Smith described what he called the "fellow-feeling," through which people take on each other's states—very similar to what I would call experience sharing.              

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That's one narrative, that empathy is automatic, and again, it’s compelling—backed by lots of evidence. But if you believe that empathy always occurs automatically, you run into a freight train of evidence to the contrary. As many of us know, there are lots of instances in which people could feel empathy, but don't. The prototype case here is intergroup settings. People who are divided by a war, or a political issue, or even a sports rivalry, often experience a collapse of their empathy. In many cases, these folks feel apathy for others on the other side of a group boundary. They fail to share, or think about, or feel concern for those other people's emotions.              

In other cases, it gets even worse: people feel overt antipathy towards others, for instance, taking pleasure when some misfortune befalls someone on the other side of a group boundary. What's interesting to me is that this occurs not only for group boundaries that are meaningful, like ethnicity or religion, but totally arbitrary groups. If I were to divide us into a red and blue team, without that taking on any more significance, you would be more likely to experience empathy for fellow red team members than for me (apparently I'm on team blue today).  

The entire post and video is here.

CIA torture survivors sue psychologists who designed infamous program

By Spencer Ackerman
The Guardian
Originally published October 13, 2015

Survivors of CIA torture have sued the contractor psychologists who designed one of the most infamous programs of the post-9/11 era.

In an extraordinary step, psychologists James Mitchell and Bruce Jessen now face a federal lawsuit for their role in convincing the CIA to subject terror suspects to mock drowning, painful bodily contortions, sleep and dietary deprivation and other methods long rejected by much of the world as torture.

In practice, CIA torture meant disappearances, mock executions, anal penetration performed under cover of “rehydration” and at least one man who froze to death, according to a landmark Senate report last year. Versions of the techniques migrated from the CIA’s undocumented prisons, known as black sites, to US military usage at Guantánamo Bay, Bagram Airfield in Afghanistan and Abu Ghraib in Iraq.

The entire article is here.

The predictive brain and the “free will” illusion

Dirk De Ridder, Jan Verplaetse and Sven Vanneste
Front. Psychol., 30 April 2013
http://dx.doi.org/10.3389/fpsyg.2013.00131

Here is an excerpt:

From an evolutionary point of our experience of “free will” can best be approached by the development of flexible behavioral decision making (Brembs, 2011). Predators can very easily take advantage of deterministic flight reflexes by predicting future prey behavior (Catania, 2009). The opposite, i.e., random behavior is unpredictable but highly inefficient. Thus learning mechanisms evolved to permit flexible behavior as a modification of reflexive behavioral strategies (Brembs, 2011). In order to do so, not one, but multiple representations and action patterns should be generated by the brain, as has already been proposed by von Helmholtz. He found the eye to be optically too poor for vision to be possible, and suggested vision ultimately depended on computational inference, i.e., predictions, based on assumptions and conclusions from incomplete data, relying on previous experiences. The fact that multiple predictions are generated could for example explain the Rubin vase illusion, the Necker cube and the many other stimuli studied in perceptual rivalry, even in monocular rivalry. Which percept or action plan is selected is determined by which prediction is best adapted to the environment that is actively explored (Figure 1A). In this sense, predictive selection of the fittest action plan is analogous to the concept of Darwinian selection of the fittest in natural and sexual selection in evolutionary biology, as well as to the Mendelian selection of the fittest allele in genetics and analogous the selection of the fittest quantum state in physics (Zurek, 2009). Bayesian statistics can be used to select the model with the highest updated likelihood based on environmental new information (Campbell, 2011). What all these models have in common is the fact that they describe adaptive mechanisms to an ever changing environment (Campbell, 2011).

The entire article is here.

Exploring Accountability of Clinical Ethics Consultants: Practice and Training Implications

Kathryn L. Weise & Barbara J. Daly
The American Journal of Bioethics
Volume 14, Issue 6, 2014

Abstract

Clinical ethics consultants represent a multidisciplinary group of scholars and practitioners with varied training backgrounds, who are integrated into a medical environment to assist in the provision of ethically supportable care. Little has been written about the degree to which such consultants are accountable for the patient care outcome of the advice given. We propose a model for examining degrees of internally motivated accountability that range from restricted to unbounded accountability, and support balanced accountability as a goal for practice. Finally, we explore implications of this model for training of clinical ethics consultants from diverse academic backgrounds, including those disciplines that do not have a formal code of ethics relating to clinical practice.

The entire article is here.

Cruel and Unuseful Punishment

Book review by Richard J. McNally
Why Torture Doesn't Work: The Neuroscience of Interrogation
Shane O'Mara Harvard University Press, 2015.
Science 16 October 2015:
Vol. 350 no. 6258 p. 284
DOI: 10.1126/science.aad2340

Here is an excerpt:

While denying that these practices qualified as torture, the Administration and its allies also invoked the "ticking time bomb" defense to justify their efforts. In this thought experiment, law enforcement officers have seized a suspected terrorist who harbors information about an imminent attack on American soil. Should interrogators torture the detainee, forcing him to disclose details of the attack? Or should their moral aversion to inflicting temporary pain cost the lives of countless innocent civilians? Advocates of enhanced interrogation argue that, although torture is abhorrent, we must do whatever we can to prevent acts of terrorism.

Legal scholars have published persuasive moral rebuttals to the ticking time bomb defense for torture (1). Yet does torture actually work? To be sure, it can compel people to confess to crimes and to repudiate their religious and political beliefs. But there is a world of difference between compelling someone to speak and compelling them to tell the truth. As Khalid Sheikh Mohammed said, "During the harshest period of my interrogation I gave a lot of false information in order to satisfy what I believed the interrogators wished to hear in order to make the ill-treatment stop." Yet the assumption underlying the ticking time bomb defense is that abusive questioning reliably causes people to reveal truthful information that they would otherwise refuse to disclose. Few scholars have scrutinized this assumption--and none with the rigor, depth, and clarity of Shane O'Mara in his excellent book, Why Torture Doesn't Work: The Neuroscience of Interrogation.

The entire book review is here.

Intuitive and Counterintuitive Morality

Guy Kahane
Moral Psychology and Human Agency: Philosophical  Essays on the Science of Ethics, Oxford University Press

Abstract

 Recent work in the cognitive science of morality has been taken to show that moral judgment is largely based on immediate intuitions and emotions. However, according to Greene's influential dual process model, deliberative processing not only plays a significant role in moral judgment, but also favours a distinctive type of content broadly utilitarian approach to ethics. In this chapter, I argue that this proposed tie between process and content is based on conceptual errors, and on a misinterpretation of the empirical evidence. Drawing on some of our own empirical research, I will argue so-called "utilitarian" judgments in response to trolley cases often have little to do with concern for the greater good, and may actually express antisocial tendencies. A more general lesson of my argument is that much of current empirical research in moral psychology is based on a far too narrow understanding of intuition and deliberation.

The entire book chapter is here.

Would You Pull the Trolley Switch? Does it Matter?

By Lauren Cassani Davis
The Atlantic
Originally published October 9, 2015

Here is an excerpt:

The trolley dilemmas vividly distilled the distinction between two different concepts of morality: that we should choose the action with the best overall consequences (in philosophy-speak, utilitarianism is the most well-known example of this), like only one person dying instead of five, and the idea that we should always adhere to strict duties, like “never kill a human being.” The subtle differences between the scenarios provided helped to articulate influential concepts, like the distinction between actively killing someone versus passively letting them die, that continue to inform contemporary debates in law and public policy. The trolley problem has also been, and continues to be, a compelling teaching tool within philosophy.

By the late ‘90s, trolley problems had fallen out of fashion. Many philosophers questioned the value of the conclusions reached by analyzing a situation so bizarre and specific.

The entire article is here.

Researchers can change the outcome of studies just by being white

By Nikhil Sonnad
Quartz
Originally posted October 5, 2015

Here is an excerpt:

The implication is that every aspect of a study matters. Decision research has been criticized for attempting to explain all of human behavior based mainly on studies of undergraduates in rich democracies. That has led to repeating such research in other parts of the world, as the chart above shows. But that might not be enough.

“Behavioral studies that offer ‘cultural’ or other contextual explanations for variation in generosity should be taken with a grain of salt, unless we are confident that such differences aren’t driven by simpler explanations such as who was in the room at the time,” said Bilal Murtaza Siddiqi, an economist at the World Bank and one of the paper’s co-authors.

The entire article is here.

Doctors' use of smartphones 'could threaten patient confidentiality'

By Denis Campbell
The Guardian
Originally published October 7, 2015

Details of patients’ illnesses and treatment could be leaked because so many doctors use smartphones to send details of their cases to each other, including x-ray results and photographs of wounds, warns research.

Patients are at risk of having their confidentiality breached because up to two-thirds of doctors are using SMS texts and picture messages to share information, including photographs of wounds, in the search for a second opinion.

The findings prompted concern that sensitive details of patients’ conditions could become public if doctors’ phones were lost or stolen or they inadvertently sent a message to a wrong number.

Research among 287 doctors and 564 nurses working at the five hospitals in the Imperial College healthcare NHS trust in London found that 65% of the doctors had used SMS messages to communicate with colleagues about a patient.

The entire article is here.

Would you have sex with a Robot?

HuffPost Live



Will humans soon enjoy the option of having sex with robots? We discuss the technology behind this progressive idea, along with legal, moral and ethical implications. How will this human like sexbot alter reality? Will relationships suffer as a result?

Originally aired on October 5, 2015

Reforming the minimum wage: Toward a psychological perspective

Laura Smith
American Psychologist, Vol 70(6), Sep 2015, 557-565.

Abstract

The field of psychology has periodically used its professional and scholarly platform to encourage national policy reform that promotes the public interest. In this article, the movement to raise the federal minimum wage is presented as an issue meriting attention from the psychological profession. Psychological support for minimum wage reform derives from health disparities research that supports the causal linkages between poverty and diminished physical and emotional well-being. Furthermore, psychological scholarship relevant to the social exclusion of low-income people not only suggests additional benefits of financially inclusive policymaking, it also indicates some of the attitudinal barriers that could potentially hinder it. Although the national living wage debate obviously extends beyond psychological parameters, psychologists are well-positioned to evaluate and contribute to it.

The entire article is here.

God and the Source of Morality — Part I

By Massimo Pigliucci
The Philosophers' Magazine online
Originally published October 5, 2015

Here is an excerpt:

Why, exactly, is this a problem for those, like Euthyphro, who think gods are the ultimate source of morality? Because if one takes the first horn — what Levin calls the “pure will” theory — then one essentially admits that morality is a matter of might makes right. If God decides that genocide and rape are permissible, then they are permissible, period. (This, as is well known, does in fact happens in several places in the Old Testament, but that’s another story.)

Recoiling from so uncomfortable an admission, Euthyphro tries the second horn, what Levin calls the “guided will” theory. But here the problem is that this route implicitly admits that there are moral standards that are external to God himself, so that morality does not, then, originate from him. (And a corollary of this conclusion is that we mortals may not need the “middle God,” so to speak, to figure out what is and isn’t moral, we can arrive at it via other sources, for instance by philosophical inquiry.)

The entire article is here.

Nudging and Informed Consent

Shlomo Cohen
The American Journal of Bioethics
Volume 13, Issue 6, 2013

Abstract

Libertarian paternalism's notion of “nudging” refers to steering individual decision making so as to make choosers better off without breaching their free choice. If successful, this may offer an ideal synthesis between the duty to respect patient autonomy and that of beneficence, which at times favors paternalistic influence. A growing body of literature attempts to assess the merits of nudging in health care. However, this literature deals almost exclusively with health policy, while the question of the potential benefit of nudging for the practice of informed consent has escaped systematic analysis. This article focuses on this question. While it concedes that nudging could amount to improper exploitation of cognitive weaknesses, it defends the practice of nudging in a wide range of other conditions. The conclusion is that, when ethically legitimate, nudging offers an important new paradigm for informed consent, with a special potential to overcome the classical dilemma between paternalistic beneficence and respect for autonomy.

The entire article is here.

Humility facilitates higher self-control

Eddie M.W. Tong, Kenny W.T. Tan, Agapera A.B. Chor, E. P.S. Koh, J. S.Y. Lee, R. W.Y. Tan
Journal of Experimental Social Psychology
Volume 62, January 2016, Pages 30–39

Abstract

Prior evidence and existing theories imply that humility engenders intra- and inter-personal attributes that facilitate self-regulatory abilities. Four experiments were conducted to test the hypothesis that humility predicts enhanced self-control. Participants who recalled humility experiences were found to be better able at sustaining their physical stamina in a handgrip task (Studies 1 and 4), resisting indulgence in chocolates (Study 2), and persevering in a frustrating tracing task (Study 3) than those who recalled neutral experiences. Studies 3 and 4 demonstrated that the effect of humility was distinct from that of self-esteem, which did not affect self-control. Study 2 ruled out two alternative hypotheses concerning achievement and compliance motives. We discuss how the findings might relate to outcomes associated with humility as evidenced in past studies.

The study can be found here.

Informed Consent and Standard of Care: What Must Be Disclosed

Ruth Macklin & Lois Shepherd
The American Journal of Bioethics
Volume 13, Issue 12, 2013

Abstract

The Office for Human Research Protections (OHRP) was correct in determining that the consent forms for the National Institutes of Health (NIH)-sponsored SUPPORT study were seriously flawed. Several articles defended the consent forms and criticized the OHRP's actions. Disagreement focuses on three central issues: (1) how risks and benefits should be described in informed consent documents; (2) the meaning and application of the concept of “standard of care” in the context of research; and (3) the proper role of OHRP. Examination of the consent forms reveals that they failed to disclose the reasonably foreseeable risks of the experimental interventions in the study, as well as the potential for differences in the degree of risk between these interventions. Although the concept of “standard of care” may be helpful in determining the ethical acceptability of other aspects of research, such as clinical equipoise, it is not helpful in discussing consent requirements.

The entire article is here.

Are Immoral Behaviors Especially Harmful, or Especially Uncivilized?

Emma E. Buchtel, Yanjun Guan, Qin Peng, Yanjie Su,  Biao Sang, Sylvia Xiaohua Chen, and Michael Harris Bond
Pers Soc Psychol Bull. 2015 Oct; 41(10):1382-94.
doi: 10.1177/0146167215595606

Abstract

What makes some acts immoral? Although Western theories of morality often define harmful behaviors as centrally immoral, whether this is applicable to other cultures is still under debate. In particular, Confucianism emphasizes civility as fundamental to moral excellence. We describe three studies examining how the word immoral is used by Chinese and Westerners. Layperson-generated examples were used to examine cultural differences in which behaviors are called "immoral" (Study 1, n = 609; Study 2, n = 480), and whether "immoral" behaviors were best characterized as particularly harmful versus uncivilized (Study 3, N = 443). Results suggest that Chinese were more likely to use the word immoral for behaviors that were uncivilized, rather than exceptionally harmful, whereas Westerners were more likely to link immorality tightly to harm. More research into lay concepts of morality is needed to inform theories of moral cognition and improve understanding of human conceptualizations of social norms.

Download the paper here.

Lawsuit: Your Candy Bar Was Made By Child Slaves

By Abby Haglage
The Daily Beast
Originally published September 30, 2015

Here is an excerpt:

In the 15 years since the documentary sparked outrage, there are more child laborers in the cocoa industry than ever before. The companies have not only failed to stop the “worst forms of child labor”; they’ve seemingly made it worse. A report released on July 30, 2015, from the Payson Center for International Development of Tulane University and sponsored by the U.S. Department of Labor found a 51 percent increase in the number of children working in the cocoa industry in 2013-14, compared to the last report in 2008-09. The number, they found, now totals 1.4 million. Those living in slave-like conditions increased 10 percent from the 2008-09 results, now totaling 1.1 million. The study concludes that while “some progress has been made,” the goal of reducing the number of children in the industry had “not come within reach.”

The California plaintiffs’ false-advertising claims against Nestle, Hershey, and Mars are the latest effort to pressure the chocolate industry to fix a problem it has known about for more than a decade. “Children that are sometimes not even 10 years old carry huge sacks that are so big that they cause them serious physical harm,” the complaint alleges.

The entire article is here.

The importance of human innovation in A.I. ethics

By John C. Havens
Mashable
Originally posted October 3, 2015

Here is an excerpt:

While welcoming the feedback that sensors, data and Artificial Intelligence provide, we’re at a critical inflection point. Demarcating the parameters between assistance and automation has never been more central to human well-being. But today, beauty is in the AI of the beholder. Desensitized to the value of personal data, we hemorrhage precious insights regarding our identity that define the moral nuances necessary to navigate algorithmic modernity.

If no values-based standards exist for Artificial Intelligence, then the biases of its manufacturers will define our universal code of human ethics. But this should not be their cross to bear alone. It’s time to stop vilifying the AI community and start defining in concert with their creations what the good life means surrounding our consciousness and code.

The entire article is here.

Call for ethical debate on sex robots

Patricia Karvelas
RN Drive
Originally published September 30, 2015

At least two companies are developing robots that can have intimate sexual relations. One is expected to release its first robot on to the market this year.

Now, a British academic believes that we need to have a conversation about the impact that human-robot sexual relations will have on wider society.

Kathleen Richardson is an anthropologist and Senior Research Fellow in the Ethics of Robotics at De Montfort University in the UK, and she has a written a paper debating the ethics of sex robots.

The 7 minute podcast is here.

Who's Sweating the Sexbots?

By Julie Beck
The Atlantic
Originally published September 30, 2015

Here is an excerpt:

Katherine Koster, the communications director of the Sex Workers Outreach Project, says that the comparison shows a misunderstanding of the sex trade. “That power relationship that they're assuming exists within the sex trade may or may not exist,” she says. “Sex workers are repeatedly saying that's not always what it looks like.”

Levy writes that the rise of sexbots will mean the decline of the sex industry, but Richardson is less convinced. She believes the introduction of sex robots will somehow further the exploitation of sex workers.

“It became more and more apparent that women in prostitution were already dehumanized, and this was the same model that they then wanted to put into these machines they’re developing,” Richardson says. “When we encourage a kind of scenario in the real world that encourages that mode of operation,we’re basically saying it’s okay for humans to not recognize other people as human subjects.” She says she plans to reach out to sex-work abolition groups around the world as part of the Campaign Against Sex Robots.

The entire article is here.

Haunts or Helps from the Past: Understanding the Effect of Recall on Current Self-Control

Hristina Nikolova, Cait Lamberton, and Kelly L. Haws
Journal of Consumer Psychology
Available online 30 June 2015

Scientific Abstract

Conventional wisdom suggests that remembering our past, and particularly, the mistakes we have made, will help us make better decisions in the present. But how successful is this practice in the domain of self-control? Our work examines how the content of consumers' recollections (past self-control successes versus failures) and the subjective difficulty with which this content comes to mind (easily or with difficulty) jointly shape consumers' self-control decisions. When successes are easy to recall, we find that people display more self-control than when they have difficulty recalling successes.  However, recalling failures prompts indulgence regardless of its difficulty. We suggest that these differences in behavior may exist because recalling failures has substantially different affective and cognitive consequences than does recalling successes. Consistent with this theory, we demonstrate that self-certainty moderates the effects of recall on self-control. Taken together, this work enhances our understanding of self-control, self-perceptions, and metacognition.

Layperson interpretation can be found here.

Professional article can be found here.

Chimpanzee choice rates in competitive games match equilibrium game theory predictions

Christopher Flynn Martin, Rahul Bhui, Peter Bossaerts, Tetsuro Matsuzawa & Colin Camerer

Scientific Reports 4, Article number: 5182 (2014)

doi:10.1038/srep05182

Abstract

The capacity for strategic thinking about the payoff-relevant actions of conspecifics is not well understood across species. We use game theory to make predictions about choices and temporal dynamics in three abstract competitive situations with chimpanzee participants. Frequencies of chimpanzee choices are extremely close to equilibrium (accurate-guessing) predictions, and shift as payoffs change, just as equilibrium theory predicts. The chimpanzee choices are also closer to the equilibrium prediction, and more responsive to past history and payoff changes, than two samples of human choices from experiments in which humans were also initially uninformed about opponent payoffs and could not communicate verbally. The results are consistent with a tentative interpretation of game theory as explaining evolved behavior, with the additional hypothesis that chimpanzees may retain or practice a specialized capacity to adjust strategy choice during competition to perform at least as well as, or better than, humans have.

The entire article is here.

UK end-of-life care 'best in world'

By Nick Triggle
BBC News
Originally posted October 6, 2015

End-of-life care in the UK has been ranked as the best in the world with a study praising the quality and availability of services.

The study of 80 countries said thanks to the NHS and hospice movement the care provided was "second to none".

Rich nations tended to perform the best - with Australia and New Zealand ranked second and third respectively.

But the report by the Economist Intelligence Unit praised progress made in some of the poorest countries.

The article and the rankings are here.

The Dark Side of Empathy

By Paul Bloom
The Atlantic
Originally published on September 25, 2015

Here is an excerpt:

Our reaction to these atrocities can cloud our judgment, biasing us in favor of war. The benefits of war—including avenging those who have suffered—are made vivid, but the costs of war remain abstract and statistical. We see this same bias reflected in our criminal-justice system. The outrage that comes from empathy drives some of our most powerful punitive desires. It’s not an accident that so many statutes are named for dead girls—as in Megan’s Law, Jessica’s Law, and Caylee’s Law—and no surprise that there is now enthusiasm for “Kate’s Law.” The high incarceration rate in the United States, and our continued enthusiasm for the death penalty, is in part the product of fear and anger, but is also driven by the consumption of detailed stories of victims’ suffering.

Then there are victim-impact statements, where detailed descriptions of how victims are affected by a crime are used to help determine the sentence imposed on a criminal. There are arguments in favor of these statements, but given all the evidence that we are more prone to empathize with some individuals over others—with factors like race, sex, and physical attractiveness playing a powerful role—it’s hard to think of a more biased and unfair way to determine punishment.

The entire article is here.

How stress influences our morality

By Lucius Caviola & Nadira S. Faber
The Inquisitive Mind
Issues 23, 2014

Here is an excerpt:

Moral judgments seem to be affected by stress only when the situation elicits an emotional reaction strong enough to be impacted by the stress reactions such as trolley-like personal moral dilemmas. For example, Starcke, Polzer, Wolf, and Brand (2011) used everyday moral dilemmas that were less extreme compared to the trolley dilemma, for example, asking participants whether they would leave a message to the owner of a car that they had accidentally scratched. They did observe an association between people’s cortisol levels and egoistic judgments in those dilemmas considered to be most emotional. However, the researchers failed to find a significant difference in judgments between stressed and non-stressed participants, presumably because the moral vignettes used in this study did not elicit emotions that were strong enough to cause a difference compared to trolley-like personal moral dilemmas.

Nonetheless, many of us are confronted with highly emotional moral situations in real life in which our judgments could be influenced by stress. For example, people might be more prone to help a child beggar on the street if they feel stressed after an uncomfortable meeting at work. Even more worryingly, doctors who face life-and-death decisions might be influenced by the daily stress they experience.

The entire article is here.

More Doubts Over The Oxytocin And Trust Theory

By Neuroskeptic
Originally published on September 16, 2015

The claim that the hormone oxytocin promotes trust in humans has drawn a lot of attention. But today, a group of researchers reported that they’ve been unable to reproduce their own findings concerning that effect.

The new paper, in PLoS ONE, is by Anthony Lane and colleagues from Louvain in Belgium. The same team have previously published evidence supporting the link between oxytocin and trust.

Back in 2010 they reported that “oxytocin increases trust when confidential information is in the balance”. An intranasal spray of oxytocin made volunteers more likely to leave a sensitive personal document lying around in an open envelope, rather than sealing it up, suggesting that they trusted people not to peek at it.

However, the authors now say that they failed to replicate the 2010 ‘envelope task’ result in two subsequent studies.

The entire blog post is here.

An Important Step in Artificial Intelligence

By Sonia Fernandez
UC Santa Barbara Press Release
Monday, May 11, 2015

In what marks a significant step forward for artificial intelligence, researchers at UC Santa Barbara have demonstrated the functionality of a simple artificial neural circuit. For the first time, a circuit of about 100 artificial synapses was proved to perform a simple version of a typical human task: image classification.

“It’s a small, but important step,” said Dmitri Strukov, a professor of electrical and computer engineering. With time and further progress, the circuitry may eventually be expanded and scaled to approach something like the human brain’s, which has 1015 (one quadrillion) synaptic connections.

For all its errors and potential for faultiness, the human brain remains a model of computational power and efficiency for engineers like Strukov and his colleagues, Mirko Prezioso, Farnood Merrikh-Bayat, Brian Hoskins and Gina Adam. That’s because the brain can accomplish certain functions in a fraction of a second what computers would require far more time and energy to perform.

The entire pressor is here.

Generation XXX

The Economist
Originally published September 26, 2015

Here is an excerpt:

Whenever pornography becomes more available, it sparks a moral panic. After the advent of girlie magazines in the 1950s, and X-rated rental films in the 1980s, campaigners claimed that porn would dent women’s status, stoke sexual violence and lead men to abandon the search for a mate in favour of private pleasures. Disquiet about the effects of online pornography is once more rising (see article). Most of it is now free. As commercial producers fight over scarce revenue, their wares are becoming more extreme. Because of smartphones, tablets and laptops, hardcore material can be accessed privately by anyone. The result is that many teenagers today have seen a greater number and variety of sex acts than the most debauched Mughal emperor managed in a lifetime.

The entire article is here.

Cultural evolution: integrating psychology, evolution and culture

Alex Mesoudi
Current Opinion in Psychology 2016, 7:17–22

Abstract

Cultural evolution represents a body of theory and findings premised on the notions that, (i), human cultural change constitutes a Darwinian evolutionary process that shares key characteristics with (but is not identical in details to) genetic evolution; (ii), this second evolutionary process has been instrumental in our species’ dramatic ecological success by allowing the rapid, open-ended generation and accumulation of technology, social institutions, knowledge systems and behavioural practices far beyond the complexity of other species’ socially learned behaviour; and (iii), our psychology permits, and has been shaped by, this cultural evolutionary process, for example, through socio-cognitive mechanisms such as imitation, teaching and intentionality that support high-fidelity social learning, and biases governing from whom and what we learn.

Highlights

• Humans have colonised and transformed every terrestrial environment on the planet.
• This ecological success can be attributed to our capacity for cultural evolution.
• High fidelity social learning allows the preservation/accumulation of cultural traits.
• Learning biases govern who people learn from and what they learn.
• These biases scale up to explain larger patterns of cultural diversity and stability.

The entire article is here.

The way to fix outrageous drug pricing in the US is simply to do what all other rich countries do

Written by Annalisa Merelli
The Quartz
Originally published September 25, 2015

Here is an excerpt:

The US is an outlier among industrialized nation: it’s the only rich country that does not offer a publicly funded health system, relying instead largely on private insurance. This affects the pricing of drugs in several ways that are independent from the actual regulations imposed on pharmaceutical companies.

First, and perhaps most importantly, the power in setting the price for drugs is skewed toward drug manufacturers. Unlike countries where universal health coverage is in place, the negotiating is left to individual care providers rather than being in the hand of a large, publicly funded buyer that’s able to negotiate since it purchases most (if not all) of the drugs.
For those with health insurance, high drug prices result in higher premiums, but it’s hard to notice the price increases directly. This means consumers lack awareness of the actual medication prices, and consequently, any pressure to keep them under control.

Plus, the costs of bringing a drug into the US market are higher, partially because of marketing expenses. The US is one of only two countries (the other being New Zealand) that allows direct-to-consumer advertisement of prescription drugs, while elsewhere promotion is limited to medical professionals. This raises the already steep marketing bill of drugs manufacturers. As Robert Yates, former World Health Organization senior health economist told Quartz, “the amount [pharmaceutical companies] spend on marketing is massively more than they do on research and development.”

The entire article is here.

Would I Accept My Patient’s Gift?

By Judith Warren
The New York Times - Opinionator
Originally published September 29, 2015

Here is an excerpt:

Delighting in the sweets, I thought of Tim’s gift as revealing both a yearning for connection and an ability to create and give something of himself. He was turning his trauma into a kind of art. I also realized that my eating his candy was an act of faith that Tim did not want to destroy our work together, even though we had struggled with many hard moments in which it seemed as if he did.

I’m embarrassed to say that I ate half the box and then fell peacefully asleep.

At his next session, I told Tim how much I enjoyed his candy. He smiled broadly, looked squarely in my eyes, and said, “So, you believed me.”

Eating Tim’s candy did not magically cure his distrust of me. But he remained in treatment for a long time. We later talked about the various meanings of this gift.

The entire article is here.

The Ethics of Suicide Digital Archive

The Ethics of Suicide Digital Archive is a partnership between the University of Utah J. Willard Marriott Library and Oxford University Press. We encourage you to participate by adding your comments in the spaces provided below each reading. You will need to create a reader account before commenting. The Digital Archive adheres to the Privacy Policy of the J. Willard Marriott Library.

Because of the serious and often delicate nature of the topic, all comments will be moderated before appearing on the website. We will not approve any comments that we find to be cruel, inconsiderate, disrespectful, or otherwise generally ill-advised, but we will welcome corrections, challenges, differences in interpretation, serious reflection, and in general comments consistent with academic freedom and the University of Utah’s Speech Policy.

The entire archive is here.

Note: This site serves as an excellent resource for those contemplating the ethics of suicide.  The archive has brief entries.  The entries are categorized by author as well as by geographical region, era, and intellectual/religious/cultural traditions.  Finally, there are categories of sin versus martyrdom.

Blocking the means of suicide can buy time and lives

By Karolina Krysinska and Jane Pirkis
The Conversation
Originally published September 23, 2015

Installing barriers and safety nets at public sites with a high incidence of suicide can reduce the number of deaths at these sites by more than 90%, according to new research we published today in The Lancet Psychiatry.

More than 2,500 Australians died by suicide in 2013 and more than 20,000 are admitted to hospital every year as a result of self-harming behaviours. Suicide also affects those who are left behind – the bereaved, who often struggle with guilt, social stigma, and the question of why.

Our study investigated interventions to prevent suicide at public sites that gain a reputation as places where people have taken their own lives. These are usually easily accessible sites, such as bridges, tall buildings, cliffs, or isolated areas, such as woods.

The entire article is here.