Friday, October 14, 2016

The drunk utilitarian

The trolley problem is a measure to evaluate psychological reasoning in morality. Using this test, researchers found that increased blood alcohol levels were associated with greater utilitarian responses to the trolley problem. Cognition. 2015 Jan;134:121-7

Comment: The trolley problem presents people with a choice of whether or not to sacrifice one life to save 5 lives. The utilitarian response is to sacrifice the 1 life in order to save 5 lives. When presented with this choice, the people in this study were more likely to make a utilitarian response when their blood alcohol level was higher. The reasons for this appear complex, but it helps to understand that in order to save the 5 lives, the person was asked whether or not they would push a person on to the trolley track, resulting in this person dying but also stopping the trolley, saving the 5 other people. This action, while utilitarian, goes against another moral principle: first, do no harm. The researchers speculate that alcohol intoxication results in a decreased aversion to harming others, so it is easier to push the one person onto the trolley track, which will result in that persons death (although at the same time saving 5 other people). Another hypothesis is that social disinhibition (created by alcohol) allows one to more easily cause harm to one person, while saving 5 other people. The take-home message of this study is not clear, but makes me wonder if conforming to social peer pressure is not always the most moral choice, and that perhaps social disinhibition is at times highly moral. For more on this, see:

Lying and the Subsequent Desire for Toothpaste: The Macbeth Effect

Physical cleansing appears efficacious in coping with threatened morality. This so-called Macbeth Effect appears to explain an increase a desire for brushing teeth after lying. Cereb Cortex. 2016 Feb;26(2):477-84

Moral Distress Amongst American Physician Trainees Regarding Futile Treatments at the End of Life: A Qualitative Study.

Physician trainees experience significant moral distress when they feel pressured to provide futile care at or near the end of life. J Gen Intern Med. 2016 Jan;31(1):93-9.

Comment: The authors recommend that trainees speak with colleagues and physician supervisors about their moral dilemmas as a way to cope. Formal education regarding end of life care may help alleviate the moral distress. Not addressing the moral distress may lead to detachment and a loss of empathy.

Impacts of Socratic questioning on moral reasoning of nursing students.

Teaching based upon the Socratic method of questioning was superior to lecture based teaching of morality. Nurs Ethics. 2016 Sep 30.

Comment: Socratic questions focus on 6 areas: 1. clarification of the issue, 2. challenging assumptions, 3. getting to the evidence, 4. exploring alternatives, 5. imagining implications and consequences, and 6. questioning of the question.

Monday, September 26, 2016

Promoting the Health of Families and Communities: A Moral Imperative.

Shifting focus from acute care medicine to community based heath care is a moral imperative, according to this author, who recommends an emphasis on building healthy communities, supporting families, and helping individuals live healthier lives. Hastings Cent Rep. 2016 Sep;46 Suppl 1:S48-51

Comment: Building healthy communities is a complex issues, with unemployment and poverty primary (but not the only) obstacles to good health. Getting people to stop bad habits and start good habits is challenging, and too often money is thrown at the problem without clear evidence as to what works, and what does not work. The problem I have with this article is that it is theoretical, and not evidence-based. The concepts are valid, but science frequently surprises us and debunks even the most logical concepts. We need more research into how to get people to change their habits for the better. This is the moral imperative, not simply adopting unproven socialist programs.

Friday, August 19, 2016

Exploring the nature of science through courage and purpose: a case study of Nikolai Vavilov and plant biodiversity.

Nikolai Vavilov was a scientist during the Stalin regime in Russia. He was vilified by political leaders, but through courage, uncompromising endeavor, and commitment to scientific understanding he helped modernize Russian crop research and contribute seeds to the worlds first gene bank. Springerplus. 2016 Jul 22;5(1):1159.

Comment: This biographical article highlights the need for scientific courage in the face of political or social pressure.

Saturday, August 13, 2016

Suicide and gender roles: Reporting distorts reality

Media reporting of suicide distorts reality. Harm is done by the media by stigmatizing mental illneses, and not fully recognizing that psychiatric illnesses can be treated, and suicide risk reduced as a result. Stereotypical reporting of men versus women suicides tends to emphasize issues other than mental health, creating negative consequences. Read More