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Expertise and Autonomy in Medical Decision Making

Written by Rebecca Brown.

This is the fourth in a series of blogposts by the members of the Expanding Autonomy project, funded by the Arts and Humanities Research Council.

This blog is based on a paper forthcoming in Episteme. The full text is available here.

Imagine you are sick with severe headaches, dizziness and a nasty cough. You go to see a doctor. She tells you you have a disease called maladitis and it is treatable with a drug called anti-mal. If you take anti-mal every day for a week the symptoms of maladitis should resolve completely. If you don’t treat the maladitis, you will continue to experience your symptoms for a number of weeks, though it should resolve eventually. In a small number of cases, maladitis can become chronic. She also tells you about some side-effects of anti-mal: it can cause nausea, fatigue and an itchy rash. But since these are generally mild and temporary, your doctor suggests that they are worth risking in order to treat your maladitis. You have no medical training and have never heard of maladitis or anti-mal before. What should you do?

One option is that you a) form the belief that you have maladitis and b) take the anti-mal to treat it. Your doctor, after all, has relevant training and expertise in this area, and she believes that you have maladitis and should take anti-mal.Read More »Expertise and Autonomy in Medical Decision Making

Cross Post: Boris Johnson Will Be Receiving The Same Special Treatment Other Patients Do In NHS Intensive Care

Written by Dominic Wilkinson, University of Oxford

This article originally appeared in The Conversation

In a world where the adjective “unprecedented” has become commonplace, the news of British Prime Minister Boris Johnson being admitted to the intensive care unit of St Thomas’ Hospital with COVID-19 seemed to take it to a new level.

There is little information in the public domain about Johnson’s medical condition, but this is clearly a very serious step. He will only have been transferred to intensive care because it is perceived that his condition is potentially life threatening and there is a possibility that he would need urgent medical attention, including the possible use of mechanical ventilation.

What would happen if that became necessary? Would Johnson’s treatment be any different from anyone else with the same condition? Would he receive special treatment because of his political position, because of his importance for the country? Would he be prioritised for a ventilator?Read More »Cross Post: Boris Johnson Will Be Receiving The Same Special Treatment Other Patients Do In NHS Intensive Care

Ecological Rationality: When Is Bias A Good Thing?

By Rebecca Brown

Many people will be broadly familiar with the ‘heuristics and biases’ (H&B) program of work, made prominent by the psychologists Amos Tversky and Daniel Kahneman in the 1970s. H&B developed alongside the new sub-discipline of Behavioural Economics, both detailing the ways in which human decision-makers deviate from what would be expected of homo economicus – an imaginary, perfectly rational being that always aims at maximising utility. For instance, in a famous experiment, Tversky and Kahneman gave people the following information (1983: 297):

Linda is 31 years old, single, outspoken and very bright. She majored in philosophy. As a student, she was deeply concerned with issues of discrimination and social justice, and also participated in anti-nuclear demonstrations. 

Participants were then asked which of the two alternatives was more probable:

1. Linda is a bank teller.

2. Linda is a bank teller and is active in the feminist movement.

Read More »Ecological Rationality: When Is Bias A Good Thing?

In Defence of Impulsivity

Written by Dr Rebecca Brown

It has become commonplace to identify a lack of impulse control as a major cause of poor health. A popular theory within behavioural science tells us that our behaviour is regulated via two systems: the fast, impulsive system 1 (the ‘impulsive’ or ‘automatic’ system) and the slower, deliberative system 2 (the ‘reflective’ system). Much of our behaviour is routine and repeated in similar ways in similar contexts: making coffee in the morning, travelling to work, checking our email. Such behaviours develop into habits, and we are able to successfully perform them with minimal conscious input and cognitive effort. This is because they come under the control of our impulsive system.

Habits have become a focus of health promoters. It seems that many of these routine, repeated behaviours actually have a significant impact on our health over a lifetime: what we eat and drink and how active we are can affect our risk of developing chronic diseases like type II diabetes, heart disease, lung disease and cancer. Despite considerable efforts to educate people as to the risks of eating too much, exercising to little, smoking and drinking, many people continue to engage in such unhealthy habits. One reason for this, it is proposed, is people’s limited ability to exert conscious (reflective) control over their habitual (impulsive) behaviour.

Given this, one might think that it would be preferable if people were generally able to exhibit more reflective control; that behaviour was less frequently determined by impulsive processes and more frequently determined by reflective deliberation. Perhaps this could form part of the basis for advising people to be more ‘mindful’ in their everyday activities, such as eating, and regimes for training one’s willpower ‘muscle’ to ensure confident conscious control over one’s behaviour.Read More »In Defence of Impulsivity

My Brain Made Me Do It — So What?

By Professor Walter Sinnott-Armstrong

Duke University

 

Vijeth: Where were you? You promised to drive me to the airport, but you never showed up, and I missed my flight. You haven’t even said sorry. Why did you let me down?

Felipe: I watched a movie instead.  It was a romantic comedy. Don’t be angry with me.

Vijeth: You watched a movie! What kind of excuse is that?

Felipe: It’s the newest kind, a neural excuse.  I really wanted to watch the movie, and my desires are lodged in my brain, so my brain made me do it.Read More »My Brain Made Me Do It — So What?

Your password will probably be hacked soon, and how to (actually) solve the problem

By Brian D. Earp

See Brian’s most recent previous post by clicking here.

See all of Brian’s previous posts by clicking here.

Follow Brian on Twitter by clicking here.

 

Your password will probably be hacked soon, and how to (actually) solve the problem

Smithsonian Magazine recently reported: “Your Password Will Probably Be Hacked Soon” and delivered a troubling quote from Ars Technica:

The ancient art of password cracking has advanced further in the past five years than it did in the previous several decades combined. At the same time, the dangerous practice of password reuse has surged. The result: security provided by the average password in 2012 has never been weaker.

After the Twitter accounts for Burger King as well as Chrysler’s Jeep were recently broken into, Twitter apparently issued some advice to the effect that people should be smarter about their password security practices. So: use lots of letters and numbers, passwords should be 10-digits or longer, use a different password for every one of your online accounts and so on.

But this is nuts. Does Twitter know anything about how human beings actually work? Why do you think people reuse their passwords for multiple sites? Why do you think people select easy-to-remember (and easy-to-discover) factoids from their childhoods as answers to security questions?

Read More »Your password will probably be hacked soon, and how to (actually) solve the problem