Tag: psychology

Bioethics Blogs

Fordham University’s Dr. Celia Fisher on Reversal of the Goldwater Rule

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The American Psychoanalytic Association announced earlier this month that members of the association no longer need to abide by the long-established “Goldwater Rule” named after 1964 presidential candidate Barry Goldwater. The rule, which can be found in Section 7.3 of the American Psychiatric Association’s (APA) Ethics Code, cautions against most psychiatrists and other mental health professionals offering opinions about an individual publicly – including the President of the United States.

According to Dr. Celia Fisher, Professor of Psychology and Director of the Fordham University Center for Ethics Education, this decision “elevated political and economic considerations above ethical principles.”

In an interview with Fordham News, Dr. Fisher stated, “Revising ethical standards to address a particularly problematic political figure or to condone the publication of a book does not reflect well on the association.  The public should be aware that the American Psychoanalytic Association organization does not represent the field of psychiatry per se, but a group of professionals who practice a particular therapeutic orientation within the mental health profession known as psychoanalysis.”

“Responsible diagnosis in psychoanalysis, as in other mental health fields, relies on assessment techniques that are characterized by interactions with and analysis of patient responses to specific established questions. A professionally and ethically responsible diagnosis cannot be determined in the absence of such interactions or assessments. For example, although the American Psychological Association has not adopted a “Goldwater Rule”, the importance of appropriate assessments are intrinsic in its ethics code, which forbids psychologists from providing opinions of the psychological characteristics of individuals if they have not “conducted an examination of the individuals adequate to support their statements or conclusions”.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Pain After Cancer: A New Model for Pain Psychology?

Guest Post by Lauren Heathcote

What if every headache, every slight twinge in your back, was potentially life threatening? What if you couldn’t tell a brain tumour from coffee-withdrawal? These can be constant, niggling worries for many people who have survived cancer, and we think their experiences can tell us something important about pain.

If you have read a Body in Mind blog post over the last few years you will likely have come across the idea that pain is all about meaning. Pain is about perceiving threat and danger to the body. The general idea is that the brain uses different types of information – including from the external and internal world through our senses, and from within brain centres that encode things like emotion and memory – to decide how much danger the body is in. The brain then produces an output based on all this information, the feeling of pain, to reflect that danger. Importantly, how we interpret painful sensations is an integral part of assigning meaning and making sense of those experiences.

So if pain is about threat – if it’s about meaning – an ideal model to study pain would be one where there is little tissue damage but a high level of perceived danger. Scientists have played around with this idea in the lab for a few decades now (like this cool study in adults and this ace study in kids). The trouble is; thanks to our cushty[1] modern ethics system, making lab participants feel like they are in extreme, life-threatening danger is understandably a bit of a no-go.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Grounding ethics from below: CRISPR-cas9 and genetic modification

By Anjan Chatterjee

The University of Pennsylvania

Anjan Chatterjee is the Frank A. and Gwladys H. Elliott Professor and Chair of Neurology at Pennsylvania Hospital. He is a member of the Center for Cognitive Neuroscience, and the Center for Neuroscience and Society at the University of Pennsylvania. He received his BA in Philosophy from Haverford College, MD from the University of Pennsylvania and completed his neurology residency at the University of Chicago. His clinical practice focuses on patients with cognitive disorders. His research addresses questions about spatial cognition and language, attention, neuroethics, and neuroaesthetics. He wrote The Aesthetic Brain: How we evolved to desire beauty and enjoy art and co-edited: Neuroethics in Practice: Mind, medicine, and society, and The Roots of Cognitive Neuroscience: behavioral neurology and neuropsychology. He is or has been on the editorial boards of: American Journal of Bioethics: Neuroscience, Behavioural Neurology, Cognitive and Behavioral Neurology, Neuropsychology, Journal of Cognitive Neuroscience, Journal of Alzheimer’s Disease, Journal of the International Neuropsychological Society, European Neurology, Empirical Studies of the Arts, The Open Ethics Journal and Policy Studies in Ethics, Law and Technology. He was awarded the Norman Geschwind Prize in Behavioral and Cognitive Neurology by the American Academy of Neurology and the Rudolph Arnheim Prize for contribution to Psychology and the Arts by the American Psychological Association. He is a founding member of the Board of Governors of the Neuroethics Society, the past President of the International Association of Empirical Aesthetics, and the past President of the Behavioral and Cognitive Neurology Society. He serves on the Boards of Haverford College, the Associated Services for the Blind and Visually Impaired and The College of Physicians of Philadelphia. 

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Refugees, Narratives, or How To Do Bad Things with Words

By Anna Gotlib

ABSTRACT. This paper addresses and critiques the anti-refugee rhetoric and policies, as well as their uncritical uptake, which developed around the candidacy of Donald Trump. My intent is to examine some of this election’s cruelest, most violent, and most racist rhetoric, reserved for Syrian (and other) refugees, and to consider some possible responses to such speech in the future. To that end, I problematize the representations and treatment of refugees within the United States from three distinct groups: European Jewish refugees of the Second World War; the Eastern Bloc refugees of the mid- and late twentieth century; and the current Syrian, largely Muslim refugees. I begin by defining the concepts of homelessness and moral luck. Second, I examine the three varying histories of refugee policies in the context of these two notions. Finally, I conclude with a combination of despair and hope: First, I offer a few observations about the role of language in the recent presidential election; second, I propose alternatives to the resulting linguistic and political violence by extending Hilde Lindemann’s notion of “holding” into sociopolitical contexts.

“How odd I can have all this inside me and to you it’s just words.”
― David Foster Wallace, The Pale King

I.  Introduction

The American election of 2016 was, in its vitriol, polarization, and outcome, unlike any in recent memory. This paper addresses and critiques the anti-refugee rhetoric and policies, as well as their uncritical uptake, which developed around the candidacy of Donald Trump. My intent is to examine and confront the fact that some of this election cycle’s cruelest, most violent, and most racist rhetoric was reserved for Syrian (and other) refugees, and to consider some possible responses to such speech in the future.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

All the Difference in the World: Gender and the 2016 Election

by Alison Reiheld

ABSTRACT. In this paper, I analyze multiple aspects of how gender norms pervaded the 2016 election, from the way Clinton and Trump announced their presidency to the way masculinity and femininity were policed throughout the election. Examples include Hillary Clinton, Donald Trump, Barack Obama, and Gary Johnson. I also consider how some women who support Trump reacted to allegations about sexual harassment. The difference between running for President as a man and running for President as a woman makes all the difference in the world.

 

IMAGE DESCRIPTION: This image shows Donald Trump on the left and Hillary Clinton on the right. Trump’s eyes are narrowed, his brow furrowed. He looks serious, and there is no hint of a smile. On the right, Clinton has a composed look with a slight, close-mouthed smile, her eyes open to a typical degree. Both are white and have greying blonde hair.

The May 21, 2007 cover of TIME magazine showed a close-up image of Mitt Romney’s face with the cover tagline “. . . he looks like a President . . .”, the first of many such claims. In 2011, as Texas Governor Rick Perry geared up for a run at the presidency, Washington Post opinion writer Richard Cohen said that Perry “actually looks like a President” (Cohen 2011). The term, here, is used as praise. Yet the power of its use as an epithet when people fail to look adequately presidential cannot be understated. During the primaries for the 2016 election, while watching Republican candidate Carly Fiorina, Donald Trump said in front of a reporter, “Look at that face!

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

The Specter of Authoritarianism

by Andrew J. Pierce

ABSTRACT. In this essay, I provide an analysis of the much-discussed authoritarian aspects of Donald Trump’s campaign and early administration. Drawing from both philosophical analyses of authoritarianism and recent work in social science, I focus on three elements of authoritarianism in particular: the authoritarian predispositions of Trump supporters, the scapegoating of racial minorities as a means of redirecting economic anxiety, and the administration’s strategic use of misinformation. While I offer no ultimate prediction as to whether a Trump administration will collapse into authoritarianism, I do identify key developments that would represent moves in that direction.

The unorthodox campaign and unexpected election of Donald Trump has ignited intense speculation about the possibility of an authoritarian turn in American politics. In some ways, this is not surprising. The divisive political climate in the United States is fertile soil for the demonization of political opponents. George W. Bush was regularly characterized as an authoritarian by his left opposition, as was Barack Obama by his own detractors. Yet in Trump’s case, echoes of earlier forms of authoritarianism, from his xenophobic brand of nationalism and reliance on a near mythological revisionist history, to his vilification of the press and seemingly strategic use of falsehoods, appear too numerous to ignore. In this essay, I attempt to provide a sober evaluation of the authoritarian prospects of a Trump administration. As presidential agendas inevitably differ from campaign platforms, much of this analysis will be unavoidably speculative. However, the nature of Trump’s carefully studied campaign, the early actions of his administration, and the wealth of philosophical reflections on earlier forms of authoritarianism provide ample resources to inform such speculation.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Don’t Feed the Trolls: Bold Climate Action in a New, Golden Age of Denialism

by Marcus Hedahl and Travis N. Rieder

ABSTRACT. In trying to motivate climate action, many of those concerned about altering the status quo focus on trying to convince climate deniers of the error of their ways. In the wake of the  2016 Election, one might believe that now, more than ever, it is tremendously important to convince those who deny the reality of climate science of the well-established facts. We argue, however, that the time has come to revisit this line of reasoning.  With a significant majority of voters supporting taxing or regulating greenhouse gases, those who want to spur climate action ought to focus instead on getting a critical mass of climate believers to be appropriately alarmed. Doing so, we contend, may prove more useful in creating the political will necessary to spur bold climate action than would engaging directly with climate deniers.

Less than a month after the 2016 presidential election, incoming White House Chief of Staff Reince Priebus stated that climate change denialism would be the “default position” of the Trump administration (Meyjes 2016). In March 2017, Scott Pruit, President Trump’s choice to lead the Environmental Protection Agency, expressed his belief—contrary to the estabilished scientific consensus—that carbon dioxide was not one of the primary contributors of climate change (Davenport 2107). Given this existence of climate denialism at the highest reaches of U.S. government, one might believe that, now more than ever, it is tremendously important to convince those who deny the reality of climate science of the well-established facts.[1] Surely, with truth on our side, we must trumpet the evidence, making deniers our primary target and acceptance of the truth of climate change our primary goal.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Cross Post: Re: Nudges in a Post-truth World 

Guest Post: Nathan Hodson

This article originally appeared on the Journal of Medical Ethics Blog 

In a recent article in the Journal of Medical EthicsNeil Levy has developed a concept of “nudges to reason,” offering a new tool for those trying to reconcile medical ethics with the application of behavioural psychological research – a practice known as nudging. Very roughly, nudging means adjusting the way choices are presented to the public in order to promote certain decisions.

As Levy notes, some people are concerned that nudges present a threat to autonomy. Attempts at reconciling nudges with ethics, then, are important because nudging in healthcare is here to stay but we need to ensure it is used in ways that respect autonomy (and other moral principles).

The term “nudge” is perhaps a misnomer. To fill out the concept a bit, it commonly denotes the use of behavioural economics and behavioural psychology to the construction of choice architecture through carefully designed trials. But every choice we face, in any context, already comes with a choice architecture: there are endless contextual factors that impact the decisions we make.

When we ask whether nudging is acceptable we are asking whether an arbitrary or random choice architecture is more acceptable than a deliberate choice architecture, or whether an uninformed choice architecture is better than one informed by research.

In fact the permissibility of a nudge derives from whether it is being used in an ethically acceptable way, something that can only be explored on an individual basis. Thaler and Sunstein locate ethical acceptability in promoting the health of the person being nudged (and call this Libertarian Paternalism — i.e.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Re: Nudges in a Post-truth World 

Guest Post: Nathan Hodson 

In a recent article in the Journal of Medical Ethics, Neil Levy has developed a concept of “nudges to reason,” offering a new tool for those trying to reconcile medical ethics with the application of behavioural psychological research – a practice known as nudging. Very roughly, nudging means adjusting the way choices are presented to the public in order to promote certain decisions.

As Levy notes, some people are concerned that nudges present a threat to autonomy. Attempts at reconciling nudges with ethics, then, are important because nudging in healthcare is here to stay but we need to ensure it is used in ways that respect autonomy (and other moral principles).

The term “nudge” is perhaps a misnomer. To fill out the concept a bit, it commonly denotes the use of behavioural economics and behavioural psychology to the construction of choice architecture through carefully designed trials. But every choice we face, in any context, already comes with a choice architecture: there are endless contextual factors that impact the decisions we make.

When we ask whether nudging is acceptable we are asking whether an arbitrary or random choice architecture is more acceptable than a deliberate choice architecture, or whether an uninformed choice architecture is better than one informed by research.

In fact the permissibility of a nudge derives from whether it is being used in an ethically acceptable way, something that can only be explored on an individual basis. Thaler and Sunstein locate ethical acceptability in promoting the health of the person being nudged (and call this Libertarian Paternalism — i.e.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Diagnostic dilemmas: When potentially transient preexisting diagnoses confer chronic harm

By Elaine Walker
Elaine Walker is the Charles Howard Candler Professor of Psychology and Neuroscience at Emory University.   She leads a research laboratory that is funded by the National Institute of Mental Health (NIMH) to study risk factors for psychosis and other serious mental illnesses.  Her research is focused on the behavioral and neuromaturational changes that precede psychotic disorders.   She has published over 300 scientific articles and 6 books. 
The diagnostic process can be complicated by many factors. Most of these factors reflect limitations in our scientific understanding of the nature and course of disorders. But in the current US healthcare climate, legislative proposals concerning insurance coverage for preexisting conditions add another layer of complexity to the diagnostic process. It is a layer of complexity that is riddled with ethical dilemmas which are especially salient in the field of mental health care. The following discussion addresses the interplay between medical practice and health-care system policy in the diagnostic process. The diagnosis of psychiatric disorders is emphasized because they present unique challenges [1]. 

Of course, some of the complications associated with diagnosis are a function of ambiguous and/or changing diagnostic criteria. For example, the criteria for designating the level of symptom severity that crosses the boundary into clinical disorder change over time as a function of scientific advances. This has occurred for numerous illnesses, including metabolic, cardiovascular, and psychiatric disorders [2]. Further, especially in psychiatry, diagnostic categories undergo revision over time, even to the extent that some behavioral “syndromes” previously considered an illness have been eliminated from diagnostic taxonomies.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.