Pauline Wallin
The Practice Institute
Originally posted August 19, 2018
Here is an excerpt:
In summary, while platforms such as Talkspace and BetterHelp provide you with ready access to working with clients online, they also limit your control over your relationships with your clients and in how you work with them.
Before signing on with such platforms, read the terms of service thoroughly. Search online for lawsuits against the company you're considering working with, and read reviews that are not on the company's website.
Also, talk with the risk management consultant provided by your malpractice insurer, who can alert you to legal or ethical liabilities. For your maximum legal protection, hire an attorney who specializes in mental health services to review the contract that you will be signing. The contract will most likely be geared to protecting the company, not your or your license.
Simon G. Talbot and Wendy Dean
STAT News
Originally published July 26, 2018
Here is an excerpt:
The term “moral injury” was first used to describe soldiers’ responses to their actions in war. It represents “perpetrating, failing to prevent, bearing witness to, or learning about acts that transgress deeply held moral beliefs and expectations.” Journalist Diane Silver describes it as “a deep soul wound that pierces a person’s identity, sense of morality, and relationship to society.”
The moral injury of health care is not the offense of killing another human in the context of war. It is being unable to provide high-quality care and healing in the context of health care.
Most physicians enter medicine following a calling rather than a career path. They go into the field with a desire to help people. Many approach it with almost religious zeal, enduring lost sleep, lost years of young adulthood, huge opportunity costs, family strain, financial instability, disregard for personal health, and a multitude of other challenges. Each hurdle offers a lesson in endurance in the service of one’s goal which, starting in the third year of medical school, is sharply focused on ensuring the best care for one’s patients. Failing to consistently meet patients’ needs has a profound impact on physician wellbeing — this is the crux of consequent moral injury.
The information is here.
Lindsey Ellefson
CNN.com
Originally posted August 15, 2018
Here is an excerpt:
"Priests were raping little boys and girls, and the men of God who were responsible for them not only did nothing; they hid it all. For decades. Monsignors, auxiliary bishops, bishops, archbishops, cardinals have mostly been protected; many, including some named in this report, have been promoted," the grand jury report said.
Though Dougherty maintained that the Vatican is treating the Catholic church less as "a moral, faith-based organization" than "a business," he told Hill that he is "at peace" now that the report is out.
Dougherty, whose abuse began when he was 10 and who gave his first statement on the ordeal in 2012, noted that Tuesday marked "the end of a very long journey." Although he has been public about his experience for some time, he said, he is "standing on the shoulders of many, many" others who came before him.
Agustin Fuentes
National Geographic Magazine
Originally published in August 2018
Here is an excerpt:
This process has deep evolutionary roots and gives humans what we call a shared reality. The connection between minds and experiences enables us to share space and work together effectively, more so than most other beings. It’s in part how we’ve become such a successful species.
But the “who” that constitutes “whom we meet” in this system has been changing. Today the who can include more virtual, social media friends than physical ones; more information absorbed via Twitter, Facebook, and Instagram than in physical social experiences; and more pronouncements from ad-sponsored 24-hour news outlets than from conversations with other human beings.
We live in complicated societies structured around political and economic processes that generate massive inequality and disconnection between us. This division alone leads to a plethora of prejudices and blind spots that segregate people. The ways we socially interact, especially via social media, are multiplying exactly at a time when we are increasingly divided. What may be the consequences?
Historically, we have maintained harmony by displaying compassion and geniality, and by fostering connectedness when we get together. Anonymity and the lack of face-to-face interaction on social media platforms remove a crucial part of the equation of human sociality—and that opens the door to more frequent, and severe, displays of aggression. Being an antagonizer, especially to those you don’t have to confront face-to-face, is easier now than it’s ever been. If there are no repercussions for it, that encourages the growth of aggression, incivility, and just plain meanness on social media platforms.
Marina Adshade
slate.com
Originally posted August 14, 2018
Here is an excerpt:
The question then is: What happens to marriage when sexbot technology provides a low-cost alternative to easy sexual access in marriage? One possibility is a reversal of the past century of societal change, which tied together marriage and sexual intimacy, and a return to the perception of marriage as a productive household unit.
Those who fear that sexbot technology will have a negative impact on marriage rates see sexbot technology as a substitute to sexual access in marriage. If they are correct, a decrease in the price of sexual access outside of marriage will decrease the demand for sexual access in marriage, and marriage rates will fall. It could just as easily be argued, however, that within marriage sexual access and household production are complements in consumption—in other words, goods or services that are often consumed together, like tea and sugar, or cellular data and phone apps. If that is the case, then, consumer theory predicts that easy access to sexbot technology will actually increase the rate of lifetime marriage, since a fall in the price of a good increases the demand for complements in consumption, just as a fall in the price of cellular data would likely increase demand for phone streaming services. Moreover, if sexual access through sexbot technology is a complement to household production, then we could observe an increase in the quality of marriages and, as a result, a reduction in rates of divorce.
Elizabeth Gibney
www.nature.com
Originally published July 26, 2018
In the midst of growing public concern over artificial intelligence (AI), privacy and the use of data, Brent Hecht has a controversial proposal: the computer-science community should change its peer-review process to ensure that researchers disclose any possible negative societal consequences of their work in papers, or risk rejection.
Hecht, a computer scientist, chairs the Future of Computing Academy (FCA), a group of young leaders in the field that pitched the policy in March. Without such measures, he says, computer scientists will blindly develop products without considering their impacts, and the field risks joining oil and tobacco as industries whose researchers history judges unfavourably.
The FCA is part of the Association for Computing Machinery (ACM) in New York City, the world’s largest scientific-computing society. It, too, is making changes to encourage researchers to consider societal impacts: on 17 July, it published an updated version of its ethics code, last redrafted in 1992. The guidelines call on researchers to be alert to how their work can influence society, take steps to protect privacy and continually reassess technologies whose impact will change over time, such as those based in machine learning.
Vivekae Kim
PBS.org
Originally posted August 5, 2018
Here is an excerpt:
To accommodate the rising call volume, Dr. Draper, the director of the Lifeline, says local crisis centers need more resources–and that a lack of resources contributes to centers leaving the network or shutting down. From 2008-2012, nine centers dropped out of the network and from 2013-2017, 23 centers dropped out. Just this year, three centers shut down.
Remaining centers do what they can to stay functioning. This often means taking on extra contracts, like running local crisis lines, to support their suicide prevention work.
Crisis Call Center, a Lifeline backup center in Nevada, operates a sexual assault support service program and a substance abuse hotline. They also provide child protective service reports and take elder protective service reports after hours. Rachelle Pellissier, its executive director, says they have to “cobble together” these different funding streams to offset the costs of the suicide prevention calls they take.
“We really need about $1.1 million to run this organization,” said Pellissier.
Centers like Provident in Missouri rely on their local United Way. The money they receive from the Lifeline, even as a backup center with more support, “pays for maybe two salaries of my 15 person team,” said Jane Smith, the director of life crisis services for Provident. “We’re a money-losing entity at Provident.”
If backup centers are unable to take a call, that call is routed from one backup center to the next, until a counselor can talk. “All the calls can be answered. The only question is, how long do people wait?” Draper said.
Noga Arikha
www.aeon.co
Originally posted July 30, 2018
Here is an excerpt:
An account of the inability to feel any emotion for such perceived enemies can take us closer to understanding what it is like to have crossed the line beyond which one can maim and kill in cold blood. Observers at the International Criminal Court (ICC) at the Hague note frequently the absence of remorse displayed by perpetrators. The clinical psychologist Françoise Sironi, who assesses perpetrators for the ICC and treats them and their victims, has directly seen what Lifton called the ‘murder of the self’ at work – notably with Kang Kek Iew, the man known as ‘Duch’, who proudly created and directed the Khmer Rouge S-21 centre for torture and extermination in Cambodia. Duch was one of those who felt absolutely no remorse. His sole identity was his role, dutifully kept up for fear of losing himself and falling into impotence. He did not comprehend what Sironi meant when she asked him: ‘What happened to your conscience?’ The very question was gibberish to him.
Along with what Fried calls this ‘catastrophic’ desensitisation to emotional cues, cognitive functions remain intact – another Syndrome E symptom. A torturer knows exactly how to hurt, in full recognition of the victim’s pain. He – usually he – has the cognitive capacity, necessary but not sufficient for empathy, to understand the victim’s experience. He just does not care about the other’s pain except instrumentally. Further, he does not care that he does not care. Finally, he does not care that caring does, in fact, matter. The emotionally inflected judgment that underlies the moral sense is gone.
Schermuly-Haupt, ML., Linden, M. & Rush, A.J.
Cognitive Therapy and Research
June 2018, Volume 42, Issue 3, pp 219–229
Side effects (SEs) are negative reactions to an appropriately delivered treatment, which must be discriminated from unwanted events (UEs) or consequences of inadequate treatment. One hundred CBT therapists were interviewed for UEs and SEs in one of their current outpatients. Therapists reported 372 UEs in 98 patients and SEs in 43 patients. Most frequent were "negative wellbeing/distress" (27% of patients), "worsening of symptoms" (9%), "strains in family relations" (6%); 21% of patients suffered from severe or very severe and 5% from persistent SEs. SEs are unavoidable and frequent also in well-delivered CBT. They include both symptoms and the impairment of social life. Knowledge about the side effect profile can improve early recognition of SEs, safeguard patients, and enhance therapy outcome.
Ephrat Livni
Quartz.com
Originally posted July 15, 2018
Here is an excerpt:
“As much as we’d love to believe bad ethics come from bad people and good ethics come from the rest of us, our everyday choices such as cutting someone off on the freeway, fudging on our taxes, taking credit for something someone else did—these are all ethical choices,” he tells Quartz. We don’t think of our individual acts as having major implications, but those are the things we can control.
In his research, he’s found that people are outraged by ethical abstractions and don’t think a lot about simple things they might be doing wrong. “When people list unethical behavior, they often cite the illegal actions of corporations or the heinous decisions of politicians–these are strong examples of a growing disregard for ethics, but what’s missing on the list are the smaller and far more numerous everyday choices we make,” Gilbert says.
He suggests using ethics as philosophical and existential guardrails that guide us as we try to climb the rungs of the moral ladder. By extending the consideration we give our actions to an ever-wider group, we succeed in being more ethical, if not perfectly moral.
Jake Rili
Saturday Down South
Originally posted August 23, 2018
Here is an excerpt:
“I believe that the sport of football has set itself up to be in a position where it shows itself in the bigger picture to not really care about women,” Beadle said on the show. “As a woman I feel like a person who has been marginalized.
“And every single one of these stories that comes out, every single time, pushes me further and further away. I realize they don’t care, but for me it’s opened up my weekends. I appreciate you for giving that to me. I don’t care anymore. I’ve lost the ability to be surprised. You got three games. You could’ve been fired. They could’ve gotten away with not having to pay you a single dime. You survived it, and not only did you survive it, but you didn’t have the grace enough to at least look over the statement you were handed seven seconds before and pretend that you meant a single word in it. The entire thing is a disgrace.”
Ryan Pawloski
The Daily Nebraskan
Originally published August 29, 2018
Here is an excerpt:
These off-field scandals were no secret back when Meyer was at Florida, and Ohio State showed that it was willing to look past them when it hired him a year after he left Gainesville.
It is evident that Ohio State kept Meyer because he wins, but the question still remains: Why did Ohio State fire Tressel after the 2011 tattoo scandal, but keep Meyer after knowing he kept a domestic abuser on his staff and lied about not knowing?
Tressel had a successful tenure as the Ohio State head coach from 2001-10 as he went 106-22 — 94-22 after NCAA sanctions — and won five Big Ten titles and one national title in 2002. Many would think that Ohio State would have kept Tressel just like it did with Meyer because he won, too.
The answer is simple. Meyer has been better for the Buckeyes than Tressel was. Tressel was one of the top coaches in the country at Columbus and any program would have taken him if he was on the market, but Meyer was better.
Meyer retired from coaching in 2010 because of health and family reasons. About six months later, Tressel was forced out by Ohio State because of NCAA violations. An explanation for Tressel’s termination was that Meyer was on the market and Ohio State knew it had a chance to get the coach it always wanted.
Paul Waldman
The Washington Post
Originally posted on August 23, 2018
Here is an excerpt:
But Trump is big on people keeping their mouths shut. As head of the Trump Organization, as a candidate and as president, he has forced underlings to sign nondisclosure agreements forbidding them from revealing what saw while in his employ. In many cases, those agreements included non-disparagement clauses in which the signer had to pledge never to criticize Trump or his family for as long as they lived. The mafia had “omerta,” and Trump has the NDA.
So how will Republicans react to Trump’s diatribe against flipping criminals? Will they try to ignore it or decide he has a point?
The thing about a cult of personality is that its character depends on the personality in question. Republicans sometimes mocked Democrats for worshiping Barack Obama, and you might argue that some of his supporters got a bit starry-eyed at times, particularly in 2008. But Obama never asked them to suddenly offer a full-throated defense of something morally abhorrent simply because the president thought it might be good for him. Whether you agreed with his policy choices, Obama was a man of great personal integrity who ran an administration free of any significant scandal. No Obama supporter ever said, “Oh my god, I never thought he’d ask me to justify that.”
Trump does, on an almost daily basis. But if his supporters are having any doubts, they might want to consider that this won’t be the last time he asks them to abandon their principles.
Scott Simon
Host, Weekend Edition, NPR
Originally posted August 11, 2018
President Trump appointed what's considered the richest Cabinet in U.S. history, and reportedly, more than half of the president's Cabinet, current and former, have been the subject of ethics allegations. There's HUD Secretary Carson's pricey dining table, VA Secretary Shulkin's seats at Wimbledon, Scott Pruitt's housing sublet from a lobbyist, Interior Secretary Zinke's charter planes, Treasury Secretary Mnuchin taking a government plane to see the solar eclipse, and Commerce Secretary Wilbur Ross might need his own category. Forbes magazine reports on many people who have accused him of outright theft, saying - Forbes magazine - quote, "if even half of the accusations are legitimate, the current United States secretary of commerce could rank among the biggest grifters in American history."
Jim Davies
The Conversation
Originally posted July 24, 2018
Here is an excerpt:
Experimental evidence suggests that people’s opinion of what God thinks is right and wrong tracks what they believe is right and wrong, not the other way around.
Social psychologist Nicholas Epley and his colleagues surveyed religious believers about their moral beliefs and the moral beliefs of God. Not surprisingly, what people thought was right and wrong matched up pretty well with what they felt God’s morality was like.
Then Epley and his fellow researchers attempted to manipulate their participants’ moral beliefs with persuasive essays. If convinced, their moral opinion should then be different from God’s, right?
Wrong. When respondents were asked again what God thought, people reported that God agreed with their new opinion!
Therefore, people didn’t come to believe that God is wrong, they just updated their opinion on what God thinks.
When you change someone’s moral beliefs, you also change their opinion on what God thinks. Yet most surveyed still clung to the illusion that they got their moral compass from what they think God believes is right and wrong.
JoAnn Grif Alspach
Critical Care Nurse
August 2018 vol. 38 no. 4 12-16
Here is an excerpt:
How Implicit Bias Is Manifested
A systematic review by Hall and colleagues revealed that implicit bias is manifested in 4 key areas: patient-provider interactions, treatment decisions, treatment adherence, and patient health outcomes. How a physician communicates, including verbal cues, body language, and nonverbal behavior (physical proximity, frequency of eye contact) may manifest subconscious bias.7,10 Several investigators found evidence that providers interact more effectively with white than nonwhite patients. Bias may affect the nature and extent of diagnostic assessments and the range and scope of therapies considered. Nonwhite patients receive fewer cardiovascular interventions and kidney transplants. One meta-analysis found that 20 of 25 assumption method studies demonstrated bias either in the diagnosis, treatment recommendations, number of questions asked, or tests ordered. Women are 3 times less likely than men to receive knee arthroplasty despite comparable indications. Bias can detrimentally affect whether patients seek or return for care, follow treatment protocols, and, perhaps cumulatively, can influence outcomes of care. Numerous research studies offer evidence that implicit bias is associated with higher complication rates, greater morbidity, and higher patient mortality.
Joshua Entsminger, Mark Esposito, Terence Tse and Danny Goh
www.thersa.org
Originally posted July 23, 2018
Here is an excerpt:
When a decision was made using AI, we may not know whether or not the data was faulty; regardless, there will come a time when someone appeals a decision made by, or influenced by, AI-driven insights. People have the right to be informed that a significant decision concerning their lives was carried out with the help of an AI. Governments will need a better record of what companies and institutions use AI for making significant decisions to enforce this policy.
When specifically assessing a decision-making process of concern, the first step should be to determine whether or not the data set represents what the organisation wanted the AI to understand and make decisions about.
However, data sets, particularly easily available data sets, cover a limited range of situations, and inevitably, most AI will be confronted with situations they have not encountered before – the ethical issue is the framework by which decisions occur, and good data cannot secure that kind of ethical behavior by itself.
Jason Pontin
www.wired.com
Originally published August 7, 2018
Here is an excerpt:
In the first stage of his plan, Mason is combining human cells with a gene called Dsup, unique to the indestructible tardigrade, that suppresses DNA breaks from radiation. Tardigrades can survive the vacuum of space; perhaps their genes might make us more fit for space, too. His lab has also created an artificial construct of the gene p53, involved in preventing cancer, which it hopes later to insert into a human cell. Elephants have many copies of p53 and seldom die from cancer; adding copies of p53 to human genomes might protect us from space radiation. Mason’s less speculative research includes editing Deionococcus radiodurans, sometimes called “Conan the bacterium,” a polyextremophile that can survive cold, dehydration, acid, and very high levels of radiation, the last by rewriting its damaged chromosomes. Mason wants the microbe to live as flora on our skin or in our guts, or on the surfaces of spaceships, protecting us from the deadly rays of space. “The microbiome is an extraordinarily plastic thing,” he says.
Some researchers have proposed more science-fictional projects. Harris Wang of Columbia wants to coax human kidney cells to synthesize the nine amino acids our bodies cannot make. A human cell able to synthesize all the organic compounds needed for health would require around 250 new genes, but if our tissues were made of such cells, astronauts could thrive by drinking just sugar water, a liberating adaptation: Missions wouldn’t have to lug bulky food or send it on ahead. Other scientists have suggested photosynthetic spacefarers, or editing the personalities of the space corps, so that they fearlessly longed for the high frontier because it was their true terminus.
Michelle Andrews
www.npr.org
Originally posted July 11, 2018
Here is an excerpt:
However, if you develop symptoms of a disease or are diagnosed with a medical condition, GINA no longer protects you. That's where the Affordable Care Act steps in. It prohibits health plans from turning people down or charging them more because they have a pre-existing condition.
"GINA did something good, and the ACA was the next important step," said Sonia Mateu Suter, a law professor at George Washington University who specializes in genetics and the law.
The Trump administration put those additional ACA protections in doubt last month when it said it won't defend that part of the law, which is being challenged in a lawsuit brought by the attorneys general of 20 states.
The administration said that since the penalty for not having health insurance has been eliminated starting in 2019, the provisions that guarantee coverage to people with pre-existing conditions and prohibit insurers from charging them higher premiums should be struck down as well.
The protections are a priority with many voters. In a June poll by the Kaiser Family Foundation, two-thirds of voters said that continuing protections for people with pre-existing conditions will be either the single most important factor or very important in determining their vote in this fall's elections.
Science News
August 7, 2018
Currently, research on embryos is limited in many countries to a maximum period of 14 days after their fertilisation in the lab.
But ethicists Dr John Appleby of Lancaster University with Professor Dr Annelien Bredenoord of University Medical Center Utrecht believe the current limit is "no longer adequate for current scientific developments."
Dr Appleby and Professor Dr Bredenoord said: "The 14 day rule has been a very successful example of international science regulation, but it should not become a dogma in itself and it should be revisited when no longer fit to purpose."
Until recently, scientists have not been able to culture and sustain embryos in vitro as long as (or beyond) 14 days but this has now changed.
"There are both scientific and ethical reasons to extent the 14 day rule to for example 28 days. Extending the window for embryo research to 28 days would allow scientists to reveal a new in-depth chapter of knowledge about the developmental processes that take place in embryos."
David Tereshchuk
Religion and Ethics - PBS.org
Originally posted July 16, 2018
Institutional regulation in science – including medical science – is undergoing one of its periodic assaults by proponents of greater freedom in research. These proponents argue (most of them in entirely good faith, I should stress) that experimentation is often needlessly hampered by too much official control. Formal constraints, they say, can cramp the kind of spontaneous improvisation that leads to unexpected, sometime spectacular, breakthroughs.
As reported by Marisa Taylor of Kaiser Health News, it has been revealed that the federal Food and Drug Administration (who won’t officially confirm this) is pursuing criminal inquiries into an egregious case of medical experimentation – conducted illicitly in off-shore locations and in hotel rooms on American soil.
The procedures under investigation were self-styled drug ‘trials’ – apparently a last-ditch effort by a university professor of microbiology, William Halford who – knowing he was dying from an incurable cancer – evidently threw both professional caution and ethics to the winds. He embarked hell-bent on a test-program for a herpes vaccine he’d invented, but for which he hadn’t gained FDA approval – a program that involved injecting it into human subjects.
Daniel Wagner
South China Morning Post
Originally posted August 6, 2018
So many businesses and governments are scurrying to get into the artificial intelligence (AI) race that many appear to be losing sight of some important things that should matter along the way – such as legality, good governance, and ethics.
In the AI arena the stakes are extremely high and it is quickly becoming a free-for-all from data acquisition to the stealing of corporate and state secrets. The “rules of the road” are either being addressed along the way or not at all, since the legal regime governing who can do what to whom, and how, is either wholly inadequate or simply does not exist. As is the case in the cyber world, the law is well behind the curve.
Ethical questions abound with AI systems, raising questions about how machines recognise and process values and ethical paradigms. AI is certainly not unique among emerging technologies in creating ethical quandaries, but ethical questions in AI research and development present unique challenges in that they ask us to consider whether, when, and how machines should make decisions about human lives – and whose values should guide those decisions.
In a world filled with unintended consequences, will our collectively shared values fall by the wayside in an effort to reach AI supremacy? Will the notion of human accountability eventually disappear in an AI-dominated world? Could the commercial AI landscape evolve into a winner takes all arena in which only one firm or machine is left standing?
Jeffrey Delfin
theguardian.com
Originally posted July 12, 2108
Here is an excerpt:
The device is not used in what we might call “electroshock therapy” – where small shocks are passed through the brain under anesthesia. Rather, the GED is used as a variation of “aversive conditioning”, in which negative stimulation is applied to a patient when he or she performs an unwanted action. The patient is awake, and feeling pain is the point of the shock.
The GED, when activated, outputs an electric shock that is distributed to the patient’s skin for up to two seconds. Students wear a backpack containing the shocking device, with electrodes constantly affixed to their skin. Staff are able to shock students at any point during the day. Previous attendees at JRC have spoken of up to five electrodes being attached to their bodies. One, Jen Msumba, who blogs about her time at the facility, said electrodes were applied under their fingers or the bottom of their feet to increase the pain.
“We’ve all experienced aversive conditioning. We touch the stove while it’s still hot, it hurts, then we become very cautious about touching it,” says Dr Jean Mercer, the leader of the group Advocates for Children in Therapy, a not-for-profit organization dedicated to ending harmful practices for treating children’s mental health.
The Editors
Scientific American
Originally published July 18, 2018
Here is an excerpt:
In states with conscience carve-outs for pharmacists, pharmacies honoring those policies should be required to preemptively notify state authorities and medical providers that they might refuse service.
That way, women and their doctors could make alternative arrangements to fill prescriptions at pharmacies that will give them the medications they need —avoiding situations like the recent one in Arizona. (This follows a model worked out in 2014, when the Supreme Court told the Obama administration that employers with moral objections did not have to offer an insurance plan with birth control coverage. But such employers did have to notify the Department of Health and Human Services so the government and insurers could provide birth control coverage via a private insurance plan or a government-sponsored one.)
And in situations where individual pharmacists may refuse service—even if their pharmacies generally fill family-planning prescriptions—there should be a legal requirement to automatically refer that prescription to another pharmacy within a certain reasonable distance or to have a backup pharmacist on call to do the work so that patients can get medications quickly and efficiently.
Fiery Cushman
Preprint
Uploaded July 18, 2018
Rationalization occurs when a person has performed an action and then concoct the beliefs and desires that would have made it rational. Then, people often adjust their own beliefs and desires to match the concocted ones. While many studies demonstrate rationalization, and a few theories identify its underlying cognitive mechanisms, we have little understanding of its its function. Why is the mind designed to construct post hoc rationalizations of its behavior, and then to adopt them? This design may accomplish an important task: to transfer information between the many different processes and representations that influence our behavior. Human decision-making does not rely on a single process; it is influenced by reason, habit, instincts, cultural norms and so on. Several of the processes that influence our behavior are not organized according to rational choice (i.e., maximizing desires conditioned on belief). Thus, rationalization extracts implicit information—true beliefs and useful desires—from the influence of these non-rational systems on behavior. This is not a process of self-perception as traditionally conceived, in which one infers the hidden contents of unconscious reasons. Rather, it is a useful fiction. It is a fiction because it imputes reason to non-rational psychological processes; it is useful because it can improve subsequent reasoning. More generally, rationalization is one example of broader class of “representational exchange” mechanisms, which transfer of information between many different psychological processes that guide our behavior. This perspective reveals connections to theory of mind, inverse reinforcement learning, and reflective equilibrium.
Asking patients why they engaged in a behavior is another example of useful fiction. Dr. Cushman suggests psychologists ask: What made that worth doing?
Ilana Stol
AMA Journal of Ethics
2018;20(8):E678-682.
Dying is a uniquely individual yet deeply shared and universal experience; it profoundly impacts perceptions of culture, personhood, and identity. For many Americans, it is also an experience widely discrepant from the one they want and envision for themselves and their loved ones. Over the past decade, there has been growing awareness of the incongruence between the way Americans say they want to die and how they actually do. But while most would agree that this reality is not the ideal that clinicians or patients strive for, what is less agreed upon is what the roles of clinicians and patients should be in defining what actually constitutes dying and good care of dying people. What do patients and clinicians need to know about dying and care at the end of life? What barriers exist to accessing and employing this knowledge in the face of difficult decisions?
To best answer these questions, it is useful to examine the social structures and supports already in place for end-of-life care and to understand how they are being utilized. To begin with, hospital palliative care programs are expanding rapidly in order to meet the physical and emotional needs of patients with serious or terminal illness. Robust evidence now exists demonstrating that early palliative care improves the dying experience for both patients and families while generally reducing health care costs and potentially prolonging survival. Despite these facts, there is significant variation in physician practice in the care of patients at the end of life and a general consensus that palliative and hospice care are underutilized by physicians.
Ian Sample
The Guardian
Originally posted July 17, 2018
The creation of babies whose DNA has been altered to give them what parents perceive to be the best chances in life has received a cautious green light in a landmark report from a leading UK ethics body.
The Nuffield Council on Bioethics said that changing the DNA of a human embryo could be “morally permissible” if it was in the future child’s interests and did not add to the kinds of inequalities that already divide society.
The report does not call for a change in UK law to permit genetically altered babies, but instead urges research into the safety and effectiveness of the approach, its societal impact, and a widespread debate of its implications.
“It is our view that genome editing is not morally unacceptable in itself,” said Karen Yeung, chair of the Nuffield working group and professor of law, ethics and informatics at the University of Birmingham. “There is no reason to rule it out in principle.”
Lev Facher
STAT News
Originally published August 1, 2018
Here is an excerpt:
Now, the NIH is seeking to bounce back from the hit to its reputation — and to demonstrate that the failures of recent years are isolated incidents and not emblematic of a broader cultural problem. At the same time, some congressional aides have hinted at more aggressive oversight of the foundation through which the NIH takes on many of its partnerships.
NIH officials told STAT this week the agency is completing a plan to ensure better ethical compliance and better delineate the actual process for private-sector collaboration. The officials said the plan will be presented to an advisory committee in December.
Already, as STAT reported in April, the NIH proactively nixed a long-touted plan to accept roughly $200 million from pharmaceutical manufacturers to pursue research on pain and addiction treatment, with an explicit acknowledgement that involving companies being sued for their role in the crisis could taint the perception of the research.
NIH Director Francis Collins acknowledged the setbacks in an interview with STAT this week, but defended his staff’s efforts.
E Price
medium.com
Originally published June 18, 2018
Here are two excerpts:
The first thing I want all lovers of science to know is this: peer-reviewers are not paid. When you are contacted by a journal editor and asked to conduct a review, there is no discussion of payment, because no payment is available. Ever. Furthermore, peer reviewing is not associated in any direct way with the actual job of being a professor or researcher. The person asking you to conduct a peer review is not your supervisor or the chair of your department, in nearly any circumstance. Your employer does not keep track of how many peer reviews you conduct and reward you appropriately.
Instead, you’re asked by journal editors, via email, on a voluntary basis. And it’s up to you, as a busy faculty member, graduate student, post-doc, or adjunct, to decide whether to say yes or not.
The process is typically anonymized, and tends to be relatively thankless — no one except the editor who has asked you to conduct the review will know that you were involved in the process. There is no quota of reviews a faculty member is expected to provide. Providing a review cannot really be placed on your resume or CV in any meaningful way.
The level of scrutiny that an article is subjected to all comes down to chance. If you’re assigned a reviewer who created a theory that opposes your own theory, your work is likely to be picked apart. The reviewer will look very closely for flaws and take issue with everything that they can. This is not inherently a bad thing — research should be closely reviewed — but it’s not unbiased either.
Jason Pontin
www.wired.com
Originally posted
Here is an excerpt:
Here’s how to speak in a polity where we loathe each other. Let this be the Law of Parsimonious Claims:
1. Say nothing you know to be untrue, whether to deceive, confuse, or, worst of all, encourage a wearied cynicism.
2. Make mostly falsifiable assertions or offer prescriptions whose outcomes could be measured, always explaining how your assertion or prescription could be tested.
3. Whereof you have no evidence but possess only moral intuitions, say so candidly, and accept you must coexist with people who have different intuitions.
4. When evidence proves you wrong, admit it cheerfully, pleased that your mistake has contributed to the general progress.
Finally, as you listen, assume the good faith of your opponents, unless you have proof otherwise. Judge their assertions and prescriptions based on the plain meaning of their words, rather on than what you guess to be their motives. Often, people will tell you about experiences they found significant. If they are earnest, hear them sympathetically.
In a novel supernatural framing paradigm, three repeated-measures experiments (N = 2347) examined whether thinking about Karma and God increases generosity in anonymous dictator games. We found that (1) thinking about Karma increased generosity in karmic believers across religious affiliations, including Hindus, Buddhists, Christians, and non-religious Americans; (2) thinking about God also increased generosity among believers in God (but not among non-believers), replicating previous findings; and (3) thinking about both Karma and God shifted participants’ initially selfish offers towards fairness, but had no effect on already fair offers. Contrary to hypotheses, ratings of supernatural punitiveness did not predict greater generosity. These supernatural framing effects were obtained and replicated in high-powered, pre-registered experiments and remained robust to several methodological checks, including hypothesis guessing, game familiarity, demographic variables, and variation in data exclusion criteria.
Ronnie de Sousa
aeon.com
Originally posted December 10, 2017
Here are two excerpts:
Much the same might be true of some of the emotional dispositions bequeathed to us by natural selection. If we follow some evolutionary psychologists in thinking that evolution has programmed us to value solidarity and authority, for example, we must recognise that those very same mechanisms promote xenophobia, racism and fascism. Some philosophers have made much of the fact that we appear to have genuinely altruistic motives: sometimes, human beings actually sacrifice themselves for complete strangers. If that is indeed a native human trait, so much the better. But it can’t be good because it’s natural. For selfishness and cruelty are no less natural. Again, naturalness can’t reasonably be why we value what we care about.
A second reason why evolution is not providence is that any given heritable trait is not simply either ‘adaptive’ or ‘maladaptive’ for the species. Some cases of fitness are frequency-dependent, which means that certain traits acquire a stable distribution in a population only if they are not universal.
The third reason we should not equate the natural with the good is the most important. Evolution is not about us. In repeating the well-worn phrase that is supposed to sum up natural selection, ‘survival of the fittest’, we seldom think to ask: the fittest what? It won’t do to think that the phrase refers to fitness in individuals such as you and me. Even the fittest individuals never survive at all. We all die. What does survive is best described as information, much of which is encoded in the genes. That remains true despite the fashionable preoccupation with ‘epigenetic’ or otherwise non-DNA-encoded factors. The point is that ‘the fittest’ refers to just whatever gets replicated in subsequent generations – and whatever that is, it isn’t us. Every human is radically new, and – at least until cloning becomes routine – none will ever recur.
Tamar Kushnir
Philosophy Compass
Originally published July 12, 2018
This paper provides an account of the developmental origins of our belief in free will based on research from a range of ages—infants, preschoolers, older children, and adults—and across cultures. The foundations of free will beliefs are in infants' understanding of intentional action—their ability to use context to infer when agents are free to “do otherwise” and when they are constrained. In early childhood, new knowledge about causes of action leads to new abilities to imagine constraints on action. Moreover, unlike adults, young children tend to view psychological causes (i.e., desires) and social causes (i.e., following rules or group norms, being kind or fair) of action as constraints on free will. But these beliefs change, and also diverge across cultures, corresponding to differences between Eastern and Western philosophies of mind, self, and action. Finally, new evidence shows developmentally early, culturally dependent links between free will beliefs and behavior, in particular when choice‐making requires self‐control.
Here is part of the Conclusion:
I've argued here that free will beliefs are early‐developing and culturally universal, and that the folk psychology of free will involves considering actions in the context of alternative possibilities and constraints on possibility. There are developmental differences in how children reason about the possibility of acting against desires, and there are both developmental and cultural differences in how children consider the social and moral limitations on possibility. Finally, there is new evidence emerging for developmentally early, culturally moderated links between free will beliefs and willpower, delay of gratification, and self‐regulation.
Parmy Olson
Forbes.com
Originally posted June 28, 2018
Here is an excerpt:
Now Parsa is bringing his software service and virtual doctor network to insurers in the U.S. His pitch is that the smarter and more “reassuring” his AI-powered chatbot gets, the more likely patients across the Atlantic are to resolve their issues with software alone.
It’s a model that could save providers millions, potentially, but Parsa has yet to secure a big-name American customer.
“The American market is much more tuned to the economics of healthcare,” he said from his office. “We’re talking to everyone: insurers, employers, health systems. They have massive gaps in delivery of the care.”
“We will set up physical and virtual clinics, and AI services in the United States,” he said, adding that Babylon would be operational with U.S. clinics in 2019, starting state by state. “For a fixed fee, we take total responsibility for the cost of primary care.”
Parsa isn’t shy about his transatlantic ambitions: “I think the U.S. will be our biggest market shortly,” he adds.
Chad Wollen
www.adexchanger.com
Originally posted July 18, 2018
With consumer trust in brands at such a low point it is worth reflecting on a home truth: Companies neglected to put the producers of “big data” – consumers – at the heart of their approach to data.
The General Data Protection Regulation (GDPR), the latest step toward building a more transparent relationship between companies and the public, represents a boiling over of concerns about data use.
Far too often, the general attitude appears to be one of companies gaming to see how rules can be observed without the overall spirit being fully embraced. The next, and arguably bigger, step is the ethical one, because it is about companies acting on their own, not because they are ordered to, to do the right thing.
What is clearly needed is a set of ethics that steer what companies can do with data – a set of truths that the industry holds to be self-evident.
In April, the industry was given a good starting point with the World Federation of Advertisers’ call for companies to adhere to a four-point plan to improve data policies. If meeting consumer needs is not enough to drive change then maybe meeting the needs of advertisers will be, and data safety initiatives can follow other moves within the industry to address issues around brand safety and accountability.
Judith Burkart, Rahel Brugger, and Carel van Schaik
Front. Sociol., 09 July 2018
The aim of this contribution is to explore the origins of moral behavior and its underlying moral preferences and intuitions from an evolutionary perspective. Such a perspective encompasses both the ultimate, adaptive function of morality in our own species, as well as the phylogenetic distribution of morality and its key elements across primates. First, with regard to the ultimate function, we argue that human moral preferences are best construed as adaptations to the affordances of the fundamentally interdependent hunter-gatherer lifestyle of our hominin ancestors. Second, with regard to the phylogenetic origin, we show that even though full-blown human morality is unique to humans, several of its key elements are not. Furthermore, a review of evidence from non-human primates regarding prosocial concern, conformity, and the potential presence of universal, biologically anchored and arbitrary cultural norms shows that these elements of morality are not distributed evenly across primate species. This suggests that they have evolved along separate evolutionary trajectories. In particular, the element of prosocial concern most likely evolved in the context of shared infant care, which can be found in humans and some New World monkeys. Strikingly, many if not all of the elements of morality found in non-human primates are only evident in individualistic or dyadic contexts, but not as third-party reactions by truly uninvolved bystanders. We discuss several potential explanations for the unique presence of a systematic third-party perspective in humans, but focus particularly on mentalizing ability and language. Whereas both play an important role in present day, full-blown human morality, it appears unlikely that they played a causal role for the original emergence of morality. Rather, we suggest that the most plausible scenario to date is that human morality emerged because our hominid ancestors, equipped on the one hand with large and powerful brains inherited from their ape-like ancestor, and on the other hand with strong prosocial concern as a result of cooperative breeding, could evolve into an ever more interdependent social niche.
Kate Devlin
unhurd.com
Originally published July 12, 2018
Here is an excerpt:
There’s no evidence to suggest that human-human relationships will be damaged. Indeed, it may be a chance for people to experience feelings of love that they are otherwise denied, for any number of reasons. Whether or not that love is considered valid by society is a different matter. And while objectification is definitely an issue, it may be an avoidable one. Security and privacy breaches are a worry in any smart technologies, which puts a whole new spin on safe sex.
As for child sex robots – an abhorrent image – people have already been convicted for importing child-like sex dolls. But we shouldn’t shy from considering whether research might deem them useful in a clinical setting, such as testing rehabilitation success, as has been trialled with virtual reality.
While non-sexual care robots are already in use, it was only three months ago, that the race to produce the first commercially-available model was won by an lifeless sex doll with an animatronic head and an integrated AI chatbot called Harmony. She might look the part but she doesn’t move from the neck down. We are still a long way from Westworld.
Naturally, a niche market will be delighted at the prospect of bespoke robot pleasure to come. But many others are worried about the impact these machines will have on our own, human relationships. These concerns aren’t dispelled by the fact that the current form of the sex robot is a reductive, cartoonish stereotype of a woman: all big hair and bigger breasts.
Elisa Gabbert
The Guardian
Originally posted August 2, 2018
Here is an excerpt:
Not long after compassion fatigue emerged as a concept in healthcare, a similar concept began to appear in media studies – the idea that overexposure to horrific images, from news reports in particular, could cause viewers to shut down emotionally, rejecting information instead of responding to it. In her 1999 book Compassion Fatigue: How the Media Sell Disease, Famine, War and Death, the journalist and scholar Susan Moeller explored this idea at length. “It seems as if the media careen from one trauma to another, in a breathless tour of poverty, disease and death,” she wrote. “The troubles blur. Crises become one crisis.” The volume of bad news drives the public to “collapse into a compassion fatigue stupor”.
Susan Sontag grappled with similar questions in her short book Regarding the Pain of Others, published in 2003. By “regarding” she meant not just “with regard to”, but looking at: “Flooded with images of the sort that once used to shock and arouse indignation, we are losing our capacity to react. Compassion, stretched to its limits, is going numb. So runs the familiar diagnosis.” She implies that the idea was already tired: media overload dulls our sensitivity to suffering. Whose fault is that – ours or the media’s? And what are we supposed to do about it?
By Moeller’s account, compassion fatigue is a vicious cycle. When war and famine are constant, they become boring – we’ve seen it all before. The only way to break through your audience’s boredom is to make each disaster feel worse than the last. When it comes to world news, the events must be “more dramatic and violent” to compete with more local stories, as a 1995 study of international media coverage by the Pew Research Center in Washington found.
