But if health authorities want to convince parents to vaccinate children in this age group against COVID, they’re going to have to acknowledge that this isn’t 2020 anymore, said Celia Fisher, Ph.D.

“One of the things we found was that the resistant and unsure parents are saying, ‘Look, the vaccine doesn’t work, because people who’ve been vaccinated are getting COVID. So why should I give it to my child?” said Fisher, the Marie Ward Doty University Chair in Ethics and director of Fordham’s Center for Ethics Education.

Just as the center did last fall, when the FDA authorized the use of vaccines for 5- to 11-year-olds, Fisher, who collaborated with Fordham graduate students Elise Bragard, Rimah Jaber, and Alliyah Gray, conducted a national survey to try to illuminate the reasons for parental vaccine resistance and hesitancy.

For the study COVID-19 Vaccine Hesitancy Among Parents of Children Under Five Years in the United States, Fisher, and her team collected data in April and May 2022, a month prior to the vaccine approval. They partnered with the survey aggregator Qualtics XM, and after receiving 1,337 responses to a call to participate, they settled on 411 English-speaking self-identified Hispanic and non-Hispanic Asian, Black, and white female guardians who were 21 or older and had children 1 to 4 years old. The results were published this month in the journal Vaccines.

They found that 31.3% of parents intended to vaccinate their child, 22.6% were unsure, and 46.2% intended not to vaccinate.

Their reasons were revealed in an open-ended section of questioning, where participants could go into greater depth about their concerns. One was the fact that the COVID BA.5 Omicron subvariant, which has become the dominant strain of the virus, is much more capable of infecting healthy people who have been vaccinated and boosted. That meant that some of the respondents had already had experience with infections, and those experiences did not lead them to automatically accept the need for vaccinations.

One mother, whose answer was classified in the study as “unsure,” wrote the following:
“The children had it, including my three-year-old, and the symptoms for him were very minor
to none. We actually had it twice and both times his symptoms were pretty minor. I also feel
like they should have some immunity against the virus now and getting shots every few months, without enough years gone by to see the side effects of the shot, just isn’t an option for us.”

Another, who was classified as “accepting,” still had safety concerns:
“I’m afraid because the words “emergency approval” kind of scares me especially when it comes to my children. I have a 3-year-old and an 8-month-old. Emergency makes it seem like it wasn’t tested as long as it needs to show proper results. However, most likely I will vaccinate my children”

Another concern that many parents also cited is the speed at which the vaccine was developed and approved. Relatedly, Fisher said it’s fair for parents to ask how many children have severe reactions to the vaccines, and in fact, the answer would allay their concerns.

“I read the data, and the data says that in fact, the vaccine has fewer side effects for young children than it does for adults. But you know, how many parents are going to read the research? The problem is that what’s effective about the vaccine is that those of us who are vaccinated are not hospitalized, and we don’t die when we get COVID. But that doesn’t necessarily get through to all parents,” Fisher said.

“Another thing is that a lot more parents have been vaccinated themselves, and have had these horrible, severe flu-like reactions [after vaccination]. They don’t want their young child to experience that.”

Compounding the problem is the fact that parents are not hearing these kinds of concerns addressed by authorities such as the Centers for Disease Control, Fisher said.

“You don’t hear on the ads that are going around that if you take the vaccine, you may get the new variant of COVID, but you won’t be hospitalized, and you won’t die,” she said.

“Nobody is addressing parents’ real concerns. They’re just saying, ‘Take the vaccine.’ And then parents are seeing that people who take the vaccine are getting COVID anyway.”

The need to recalibrate messaging on vaccines is taking on more importance, as recent statistics indicate that a year after vaccines became available to children between 5 and 11, fewer than 40 percent of that population has received two shots of the COVID vaccine, she said.

Research has found that children in that age range are more likely to suffer long-term side effects from COVID than from vaccines, and even though children who are infected generally suffer less severe symptoms than adults, they’re not immune. In rare instances, their symptoms can be very severe, and that shouldn’t be discounted by a parent who’s trying to decide whether to vaccinate or not.

But that can only be done if parents’ concerns are addressed, Fisher said.

“There is this very small percentage of parents that are resistant for resistance’s sake, whereas there are others who are just either misinformed or are highly concerned,” she said.

“What I’m hoping is that, because we did these narratives that allowed parents to speak in their own voice, it will alert pediatricians who are talking to parents to ask them what their concerns are, rather than just tell them, ‘The vaccine’s safe, your child should take it.’ That’s not going to work.”

“One of the greatest aspects of this experience for students is that they are required to take both sides of an issue. It teaches them how to not only defend a particular position that they have, but also to modify it and take the perspective of those who may have a very different understanding of the issue,” said Celia B. Fisher, Ph.D., Marie Ward Doty University Chair in Ethics, psychology professor, and director of several Fordham organizations. “It also moves us toward a more inclusive form of citizenship, which we need right now in this time of polarization.” 

Navigating ‘Thorny Ethical Issues’

For more than two decades, college students across the U.S. have competed in the national bowl and debated moral dilemmas. 

“It’s really important to get people together to talk through these sorts of conflicts,” said Steven Swartzer, Ph.D., coach and advisor for Fordham’s team and associate director for academic programs and strategic initiatives at Fordham’s Center for Ethics Education. “If you have people come together who are willing to try to figure out how to listen empathetically and see what’s driving the ideas of the other person, I think we can make a lot of progress when it comes to thorny ethical issues.” 

This semester, Swartzer formed a team of six students from Fordham College at Rose Hill, Fordham College at Lincoln Center, and the Gabelli School of Business. They met weekly on Zoom and studied 15 case studies that were provided in advance of the competition. Among the debate topics were the moral justification behind acts of political violence, including this past summer’s protests over the murder of George Floyd, and whether or not Harry Potter fans who have rejected J.K. Rowling’s controversial tweets about the transgender community should also reject her work. 

The team prepared with mock presentations, commentaries, and Q&A sessions, with Swartzer acting as judge. On game day, they wore Fordham maroon to the competition. 

In addition to the normal challenges of working remotely as a team, the group had to overcome some unique obstacles.

Victoria Munoz, a senior accounting major at the Gabelli School of Business and a student in the Accelerated BA/MA in Ethics and Society program, competed two hours ahead of her teammates. She logged in from El Paso, Texas, where the competition start time was 6 a.m., while her three teammates on the East Coast settled in at their computers at 8 a.m. Every time she entered or left a Zoom breakout room, there was also a slight time delay due to technical glitches on Munoz’s end. 

“We only had three minutes to prepare [our statement]. So instead of three minutes, I had two minutes and 30 seconds,” Munoz said. “And for the Q&A section, you only got a 30-second conference period, but our team wouldn’t even take it because by the time I’d get in, we’d have to come out. That was a disadvantage for sure.” 

Debating Dementia and Housing Evictions Amid COVID-19

In their first round against Yale, Munoz and her teammates debated the ethics behind concealing medication in food for dementia patients who were no longer lucid. They argued it was unethical, and won their case. 

“Upholding a patient’s dignity is sometimes put on the back-burner with our healthcare system, because everyone’s so overworked and rushing. So we said that it was understandable that a healthcare worker would want to conceal the medication, but ultimately, that wasn’t the most ethical thing to do,” Munoz said. 

“If we want to be completely ethical, we would have to devote time into restructuring our healthcare system to allow for each patient to have the time needed.” 

Another case considered the morality of housing evictions in a pandemic. Jada Heredia, a junior political science and philosophy major at Fordham College at Lincoln Center, argued that evictions shouldn’t occur during a pandemic because they would increase the danger of viral transmission to the local community. There were other factors to consider as well: What about landlords losing income? Is the relationship between landlords and tenants fundamentally exploitative? Should people have to pay for shelter? How can society reorganize the housing system to make it non-exploitative, yet meet everyone’s basic human needs? 

“There is no such thing as a solitary issue,” said Heredia, who plans to work in the legal profession. “Every case where there’s an ethical dilemma always relates to a greater system; set of values; institution; or network of causes, effects, and impacts on people that requires consideration as well.”

The team placed 13th out of 20 teams, winning against one of two teams from Yale University, losing to the United States Military Academy at West Point and Boston College, and tying with University of Maryland, College Park. 

“This competition made me realize that every single industry will [relate to]ethics,” said Munoz, who plans on becoming a certified accountant and will advise companies on how their accounting processes can be more ethical as an intern at Deloitte next summer. 

“It’s always been true, and it’s growing to be even more true now.”

Celia Fisher, Ph.D., knew she was onto something in 1997 when she asked Joseph M. McShane S.J., president of Fordham who was then dean of Fordham College at Rose Hill, to fund a series of faculty seminars around the topic of ethics. In 1999, the success of those seminars led to the creation of the Center for Ethics Education.

Twenty years later, Fisher, the Marie Ward Doty University Chair in Ethics, says she’s still amazed at what the center has accomplished. The center, which received initial funding from the National Institute of Health and Fordham’s Graduate School of Arts and Sciences, currently oversees educational programs on the undergraduate, graduate, and post-graduate level. It has produced over 200 publications and has received a total of $11 million to conduct research supporting the rights and welfare of vulnerable populations. For the past eight years, it has also administered the HIV and Drug Abuse Prevention Research Ethics Training Institute.

Interdisciplinary From the Start

Fisher said one of the center’s greatest points of pride has been its interdisciplinary focus.

“The center’s success was built on the support, encouragement, and involvement of faculty of all the different schools and programs at Fordham,” she said.

“To be able to put all that together with the support of an interdisciplinary faculty, advisers, and teachers has been an incredibly wonderful experience.”

From the very beginning, Fisher, whose background is in psychology, has had two associate directors hailing from the theology and philosophy departments. Curran Center for Catholic Studies Director Christina Firer Hinze, Ph.D., represented theology when the Center for Ethics Education started and was followed by Barbara Andolsen. Currently, the position is held by theology professor Thomas Massaro, S.J.

Michael Baur, Ph.D., an associate professor of philosophy and adjunct professor of law, joined in 1999 as associate director and never left. It helps, he said, that he is “constitutionally built” to be interdisciplinary.

“For those who are predisposed to think beyond boundaries, the center provides a huge playground of full opportunities to think creatively about different disciplines,” he said.

“The center has made it really easy for me to start conversations with people I never would have spoken with about economics, psychology, biology, and neurosciences.”

In 1999, Baur recalled, the goal of the center was to create a space for crossing boundaries to address ethics and being open to whatever came along as a result. The interdisciplinary minor in bioethics, which was first offered to undergraduates in 2013, is an example of how the center has evolved to meet the needs of students.

“We already had the goodwill and the communications among different faculty. We didn’t have to reinvent the wheel,” he said.

Debating Issues of the Times

When it comes to public programming, the center, which kicked off its 20th-anniversary celebration with a March 7 lecture titled “Ethics and the Digital Life,” has hosted events dedicated to nearly every thorny issue debated in the United States today.

Its first public event was an April 2000 workshop titled “The Ethics of Mentoring: Faculty and Student Obligations.” In a lecture four years later, Christian ethics professor Margaret Farley, Ph.D. weighed in on the use of human embryonic stem cells in research. The drug industry was the focus of a 2005 forum, “Bio-Pharmaceuticals and Public Trust,” and in 2012, the center co-sponsored “Money, Media and the Battle for Democracy’s Soul,” where former Senator Russ Feingold issued an ominous warning about the role of money in politics.

In 2013, a conference tackled the uncomfortable reality that the United States accounts for about 5 percent of the world’s population, but is home to nearly a quarter of the world’s prison population. Four years later, the center’s decision to co-sponsor “In Good Conscience: Human Rights in an Age of Terrorism, Violence and Limited Resources,” proved prescient, with the actual lecture coming two weeks after terrorist attacks in Brussels.

For Fisher, one of the most emotional events was “Moral Outrage and Moral Repair: Reflections on 9/11 and Its Afterlife,” a daylong conference co-organized with Fordham’s Center on Religion and Culture in April 2011.

“It was so moving. We had clerics from all different religions, we had philosophers talking about forgiveness, all sides of it. We had survivors and families of survivors. It was such an emotional experience,” she said.

A Flexible Master’s Program

The center’s efforts are not confined to lectures and panels. In 2009, at the suggestion of former Graduate School of Arts and Sciences Dean Nancy Busch Rossnagel, Ph.D., the center began offering a Master of Arts in ethics and society under the direction of Adam Fried, Ph.D, GSAS’ 13, 17. It is now overseen by Rimah Jaber, GSAS’ 16.

Yohan Garcia, GSAS ’18, one of the program’s 57 alumni, recently accepted a position as national formation coordinator for the Archdiocese of Chicago’s Pastoral Migratoria (Migration Ministry) program.

A native of Mexico who moved to the Belmont neighborhood in 2003, Garcia earned an undergraduate degree in political science from Hunter College in 2015. In 2013, he attended a spiritual retreat and realized he wanted to incorporate his faith into his studies. As a Fordham master’s student, he took classes such as Natural Law (at the Law School); Race, Gender and the Media; and Introduction to Thomas Aquinas. Today, he’s able to apply what he learned in each of those courses to his work around immigration.

Although he’s only just started his job in Chicago, he’s already considering applying to Ph.D. programs.

“When it comes to issues like immigration, there’s no easy solution,” he said.

“We all have a different idea of the common good, but at the end of the day, as a society, we have to work toward a common goal that will benefit all of us. Listening is a great skill and a gift to have when it comes to this issue.”

HIV Research Training

Faith Fletcher, Ph.D., an assistant professor of health behavior at the University of Alabama at Birmingham, completed training with the HIV and Drug Abuse Prevention Research Ethics Training Institute (RETI) in 2016. The institute, which is funded by the National Institute on Drug Abuse, has to date provided over 42 early career professionals in the social, behavioral, medical, and public health fields with an opportunity to gain research ethics training.

A native of Thibodaux, Louisiana, who was one of the first students to pursue a bioethics minor as an undergraduate at Tuskegee University, she has focused on the ethics of engagement with African American women living with HIV.

“Before coming to the research ethics training institute, I had training in both bioethics and public health, but I really struggled with finding the academic spaces, and even the language to combine these disciplinary areas,” Fletcher said.

“The institute is definitely the highlight of my academic career.”

Because she works with marginalized populations, Fletcher said her biggest challenge is avoiding situations that jeopardize the safety of them or researchers. It’s a real issue, as researchers engaged in qualitative research sometimes conduct interviews in vehicles, bars, and other unorthodox places to make sure the people they are interviewing are not further stigmatized.

“What I’ve learned from the training is we have to rely on research participants as research ethics experts, because they have these daily experiences with stigma, and are skilled at navigating and circumventing stigma. These are the individuals we have to go to as we’re designing our research ethics protocols,” she said.

It’s humbling work, and Fletcher said the women she’s interviewed have taught her much about resiliency.

“I’ve learned so much about the way that they’re able to navigate through society despite high levels of stigma and stress, and the way they’ve coped with it, risen above it, and not allowed it to define them,” she said.

“I’m thankful for them allowing me into their spaces, because not only does it enhance my research, but I’ve grown personally from their stories.”

Protecting the rights and welfare of vulnerable populations has been a common theme running through the centers’ NIH-sponsored research. For instance, Fisher was the principal investigator on a 4-year series of studies designed to reduce the burden of HIV among young sexual and gender minority youth.  The results of one of these studies were published in the journal AIDS and Behavior.

In 2014, based on a project supported by the Fordham’s HIV, Research Ethics Institute, Cynthia Pearson, Ph.D., was awarded a grant, along with Fisher, to adapt a culturally specific ethics training course for American Indian and Alaska Natives populations. Fisher also led a study in 2006 to assess and develop procedures to enhance the capacity of adults with mild and moderate mental retardation to provide informed consent for therapeutic research; the results were published in the American Journal of Psychiatry.

A Shared Dedication to Social Justice

Going forward, Fisher said she wants to expand the involvement of the faculty and alumni in center programming, recruit more international students, and establish a research center on health disparities among marginalized populations.

Since its beginnings, the Center has been grounded in Fordham University’s commitment to intellectual excellence, human dignity, and the common good. The success of the center, she said, is due in no small part to the breadth and depth of Fordham’s faculty dedication to these ideals.

“Faculty, students, and administrators share this dedication to social justice and helping others that just implicitly supports what we’re doing. So, when we reach out to faculty, they are already providing students with the tools for critical and compassionate engagement in creating a just world,” she said.

“They may not do work in ethics per se, but the way they think, because they’re at Fordham, they are committed to caring for the least among us.”

“What Happened? Why? What Now? Clergy Sexual Abuse in the Catholic Church” brought together experts in law, psychology, and theology to talk about new developments in the ongoing crisis, such the Pennsylvania Attorney General’s August report detailing how more than 300 Catholic priests there sexually abused children over seven decades and were protected by a hierarchy of church leaders.

It was the first in what organizers said will be a series of events dedicated to the crisis, and was preceded by a full minute of silence in honor of the victims.

The End of Piecemeal Reforms

Bryan N. Massingale, S.T.D., professor of theological and social ethics and the James and Nancy Buckman Chair in Applied Christian Ethics at Fordham, called the Pennsylvania revelations, as well as those relating to the abuse and cover up involving former Cardinal Theodore McCarrick, “sexual abuse crisis 3.0.”

The first highly publicized incident of abuse, involving a Louisiana priest who was convicted of pedophilia in 1985, was dismissed as an aberration, Massingale said. Then in 2002, the Boston Globe published a report showing the abuse was more widespread, but it was still seen as an American phenomenon confined to wayward priests.

Now, he said, victims are coming forward from around the globe, which is proof that the whole church hierarchy is to blame. The entire process of priest formation needs to be reformed, he said, with less emphasis on the virtue of obedience.

“What we’re seeing is an interrogation of a monarchical system of power, where the people who have power in the church are not accountable to anyone except the person above them, and there are no women in the chain of command, and no lay people in the chain of command,” he said, noting that few outside the church believe church leaders are capable of policing themselves.

“We have reached the end of piecemeal reforms.”

M. Cathleen Kaveny, Ph.D., the Darald and Juliet Libby Professor of Law and Theology at Boston College, concurred, and said it’s important that the church submit itself to appropriate legal procedures and use secular best practices to make sure the abuse never happens again.

“At the same time, its extremely essential that we use and develop our own theological and ethical language to understand why this is a problem, not just for citizens in the secular society who are harming one other, but also for fellow members of the body of Christ, to see how that is harming us as church,” she said.

Time to Rethink Priest Formation

The relationship between priests and bishops was a major point of discussion. Father Massingale noted that at its best, the relationship takes on a benevolent father-son dynamic. At its worst, a priest can become psychologically dependent on the bishop, thus becoming vulnerable to being used to cover up for him or for others.

Celia B. Fisher, Ph.D., the Marie Ward Doty University Chair in Ethics, professor of psychology, and director of Fordham’s Center for Ethics Education, echoed Father Massingale’s strenuous assertion that homosexuality is not in any way connected to the abuse perpetrated by priests.

Men who molest young boys are immature heterosexuals who find themselves identifying more as a child than as an adult, she said. She noted that national studies have found that priests who have abused children do not display evidence of mental illness or urges associated with pedophilia.

And covering up the abuse, Fisher said, has only compounded and spread the pain further.

“People who are deeply religious are more likely to believe in the power of forgiveness, however the severity of harm perpetuated on children, the violation of the clerics’ position of trust and moral authority, repetition of abuse by individual clerics, and the past unwillingness of the church to recognize these problems is making forgiveness difficult for many Catholics,” she said.

Why Now?

To the question of why, David Gibson, director of Fordham’s Center of Religion and Culture, added, “Why now?” For starters, he noted that in 2002, American bishops went after the “low-lying fruit,” by focusing on priests and exempting themselves from scrutiny.

“I remember talking to a bishop I’ve known pretty for a pretty long time. I said, ‘What about you guys?’ And he said to me, ‘I don’t even know how you fire a bishop,’” he said.

Gibson said that the Pennsylvania grand jury report added narratives to what had previously been dry statistics, and their impact was heightened by the revelations of Cardinal McCarrick’s conduct that had come out just a month before. Just as important, Gibson noted, is that conservative Catholics have come out in favor of investigations they’d previously resisted, and law enforcement officials are no longer turning a blind eye.

Finally, he said, it’s become apparent that the problem is not confined to Anglophile countries such as the United States, Ireland and Australia.

“It turns out we were the leading edge of a wave of that’s now breaking around the world, in places like Chili, Guam, Mexico, Poland, and Italy,” he said.

“This is all emboldening victims, empowering them, and more of them are speaking out. And when victims speak out, that’s more effective than any media investigation or grand jury report.”

The panel was co-sponsored by Fordham’s Department of Theology, Francis and Ann Curran Center for American Catholic Studies, and Institute on Religion, Law, and Lawyer’s Work.

That was the message of “Conscience Matters: Tensions between Religious Rights and Civil Rights,” a panel discussion hosted on April 19 by Fordham’s Center for Ethics Education.

The panel, which was held at the Lincoln Center campus, featured Linda Greenhouse, the Joseph Goldstein Lecturer in Law and Knight Distinguished Journalist-in-Residence at Yale Law School, and Nancy Berlinger, Ph.D., a research scholar at the Hastings Center, a bioethics research institute.

Greenhouse and Berlinger tackled the thorny issue of conscience-based refusals from the perspective of the law and the medical establishment, respectfully. Greenhouse, who covered the Supreme Court for The New York Times for three decades, spoke at length about one case that the high court ruled on in 2014, Burwell v. Hobby Lobby, and another, Masterpiece Cakeshop v. Colorado Civil Rights Commission, which was argued in December and is still pending.

A Threat to Civic Society

Greenhouse was unsparing in her criticism of the courts’ willingness to grant exceptions based on “deeply held religious beliefs,” saying they undermine civic society and are granted with little consideration for the adverse effects they may have on others.

Sometimes the court grants exceptions even when it’s not clear that a person’s rationale is based on sound theology, she said. In the 2015 case Holt v. Hobbs, for instance, the court ruled unanimously that a prison’s rules against beards violated the rights of a prisoner who said it comported with his Muslim faith. Greenhouse noted that nowhere in the Quran does it explicitly stipulate men maintain facial hair.

The Hobby Lobby case, in which the court ruled in favor of a private business that defied a government rule that employers must provide birth control under the health plans they offer, is even more egregious, she said. The Hobby Lobby CEO tied his decision to his Christian faith, but he’d abided by the government rule previously. Greenhouse dryly noted that the owner also had no problem with the violation of Christian strictures when his employees used their salaries to purchase birth control themselves.

In a way, the Masterpiece Cakeshop case, in which a baker says his Christian faith prevents him from baking a wedding cake for a gay couple, is even more ludicrous, she said. That’s because the case has hinged on whether his First Amendment rights will be infringed upon if he’s forced to bake a cake for them. She noted that cake is a poor vehicle for arguments about freedom of expression.

“Once it gets to the party, it’s just a cake. It’s not like he signed the cake. It’s not like a Van Gogh with the signature on it,” she said. “He doesn’t have to associate with or attend the [wedding]  party.”

Step Away, Don’t Step Between

Berlinger said that when it comes to medical treatment, there are actually very few cases in which medical personnel refuse to provide care. There may be instances when patients who are Jehovah’s Witnesses object to blood transfusions, and Orthodox Jews may dispute a doctor’s judgement of brain death.

But a bigger threat, she said, are structural issues, such as medical residents who simply opt not to get training for controversial procedures like abortion, and those who stall when faced with patients who inquire about physician-assisted suicide.

She said a conscience clause that the Hastings Center advocates says that even health professionals who feel more than the usual sense of “moral distress” that comes with working in the medical field must fulfill their duty of care. There’s no option to abandon a patient if their needs conflict with doctor’s conscience.

“You also cannot interfere with your patients’ access to care by others,” she said. “Sometimes the way this is explained is, ‘You can step away, but you can’t step between.”

She quoted British ethicist Alan Cribb, Ph.D., professor of bioethics and education at King’s College London, as having summarized it perfectly:

“We may exercise conscience objection to involvement in certain activities, but surely we cannot float entirely above the network of obligations in which we have emerged ourselves.”

Editors note: On July 25, the American Psychoanalytic Association announced it no longer expected its members to abide by the so-called “Goldwater Rule, a code of ethics prohibiting most psychiatrists from giving opinions about the mental state of anyone they have not evaluated.” Celia Fisher, Ph.D., the Marie Ward Doty University Chair in Ethics, professor of psychology, and director of Fordham’s Center for Ethics Education, discussed the rationale for the rule in February. 

Below, she explains why the July 25 decision is an unfortunate one that elevated political and economic considerations above ethical principles.

“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,” she said.

“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”. To be sure, the mental health profession can and should share their knowledge with the public, but irresponsible “diagnosis” diminishes the profession and does not serve the public it seeks to inform.”

Stream the February interview with Fisher on this topic below.

The center’s staff wrote about the ethics of diagnosing from afar on March 7 and Aug. 16 of last year, and again on Jan. 30 of this year. To find out why it’s such a big deal, we sat down with Fisher. Listen below:

Full transcript below

Patrick Verel: This is Patrick Verel, and today I’m speaking with Celia Fisher, the Marie Ward Doty University Chair and Ethics, Professor of Psychology, Director of the Center for Ethics Education, and author of the book, Decoding the Ethics Code: A Practical Guide for Psychologists.

The issue of diagnosing someone from afar is something that the ethics blog addressed. Why does this keep coming up?

Celia Fisher: I think it keeps coming up for a number of reasons. Obviously this year we’ve had a presidential candidate and now a president who has a style that is clearly very different from what we’ve ever seen before. There’s a lot of attention to the why’s and reasons for his proclamations and for his behavior, so I think there’s media attention that’s being drawn to this. I think there’s a social interest that’s being drawn to this, and the extent to which some of the unusual comments and behaviors reflect some kind of psychological probably or whether it’s just a very interesting idiosyncratic type of character that we now have in the public sphere.

Patrick Verel: Now you argue that people who are attempting to attribute mental problems like narcissism to political figures that they disagree with are actually, they’re doing a disservice to themselves, right? Can you explain that a little bit more?

Celia Fisher: Well I think they’re doing a disservice to both the professions of psychology and psychiatry, as well as to the public and the political spheres. People go to mental health professionals for a formal evaluation based upon not only the professional’s training, but also measures that have been validated, that are known to be able to predict and understand somebody’s mental health.

One can only assess somebody’s mental health in a one on one interview using these type of valid and reliable measures. When somebody is attempting to diagnose from afar, they are actually performing nonpsychology, nonpsychiatry. They can be diminishing the trust that individuals who do need some kind of mental health assessment can have in such professionals who are providing these offhanded kinds of diagnoses.

Patrick Verel: I feel like there’s a term I’ve heard, is this arm chair psychology?

Celia Fisher: Arm chair psychology has a history of when psychology broke away from philosophy, and in fact psychologists wanted to be legitimate in their own right because they used the scientific method to develop ways of assessing people. So right now, that term I think is very appropriate for people who are sitting and saying, “My views of the world, my reading of what President Trump says or anybody else says, I can now without applying any type of diagnostic instrument, figure out what category they’re in.”

Patrick Verel: Americans are obviously more polarized now than we have been in probably a good generation or two. Is it fair to say that they’re also more likely to attribute the differences of other people that they disagree with to mental deficiencies?

Celia Fisher: I don’t know if there’s a newer trend to do that just because of the politicization and the polarization of our society right now, but I think that what has happened is, is that rather than look at intent and looking at whether or not somebody is strategic in what they’re doing, there’s a tendency to say, “If somebody is voicing something that I find so inconsistent with my own values, they must be crazy.”

I think that that’s very harmful, but what it does is is it takes us away from looking at somebody as a full person who may actually be very rational in their impulsive, or seemingly irrational statements. A mental disorder is something that people do not have control of. In fact, it takes away from their autonomy to make decisions. Whereas sometimes, very dramatic, unconventional statements can be very strategic in terms of turning public attention to certain issues, and turning public attention away from certain issues.

In that way I think it’s very dangerous for mental help professionals to come out with these kind of, as you call them, arm chair psychology diagnoses, which really turn the public’s attention away from what the intent and the ramifications are of some types of extreme political statements that may really be incredibly strategic, and then simply say, “Well, it’s the result of a disorder.”

Patrick Verel: I guess it’s just sort of like a crutch to just say, “Well they’re crazy.”

Celia Fisher: Exactly. I think if you look at the way that both the people that voted for Trump, and some of the people who didn’t vote for Trump, well many of them said, “Well he doesn’t mean that.” Now we’re seeing that he did mean what he was saying, and so to off handedly just dismiss somebody’s language, what they say are their intentions either because you don’t want to believe that that’s what’s true, or you’re trying to say, “Well, it’s just some impulsive behavior that can be controlled,” I think is very damaging to both sides of the political spectrum.

Patrick Verel: How can the field of ethics help bridge these kinds of divides?

Celia Fisher: What I think is that ethics is incredibly important in terms of integrity right now, because what we’re hearing about this term fake news, and the fact that lies and fake incidences are being promulgated across the social media is very dangerous. I think also the term fake news is dangerous because many of the untrue information that’s coming across is actually propaganda, and there’s an intention behind it.

Fake news makes it sound like it’s comedic, or it’s not important, or it’s a cartoon, but actually propaganda has a very specific intention, and that is to undermine the truth, and I think that ethics is now more important than ever to really come out and say, “When is something untrue. When is something intentionally untrue,” which we must call a lie and a falsehood when that exists.

]]> 64200 https://now.fordham.edu/science/the-chynn-family-endows-100000-for-prize-in-ethics/ Fri, 28 Sep 2012 17:29:41 +0000 http://news.fordham.sitecare.pro/?p=41181 Dr. K. York Chynn and M. Noelle Chynn, GSS ’60, have made a $100,000 gift to the Center for Ethics Education to endow an essay prize that asks undergraduate students to delve deep into their personal experiences to find moments that taught them about moral choices.

By creating a prize that stimulates self-examination on morality and ethics, the Chynns’ generous gift “reflects the larger mission of the University, which emphasizes moral development in tandem with intellectual development”, said the Center’s Director, Celia B. Fisher, Ph.D., Marie Ward Doty University Chair and professor of Psychology.

Fisher added that the prize has a trickle down effect, in the best sense of the term: No one loses a contest that challenges one to answer questions like, “What personal characteristics are essential to a moral life?”

The University wide prize sprung from an initial contest this past spring where more than 100 students submitted essays on ethical and moral issues and dilemmas they encountered personally or as a concerned member of society. Three students won prizes of $300, $500, and $1,000.

The grant will fund a five-year training program that will teach HIV investigators to identify and address ethical issues in HIV-prevention research.

Fordham faculty members and other international experts will conduct the program.

In addition to lectures and skills-based activities, trainees will gain experience by engaging research participants and communities in the construction and evaluation of research protections, which are rules that researchers use to preserve the safety and dignity of the people they are studying.

Ultimately, the program will generate empirical data that can be used to inform ethical procedures and policies in HIV-prevention science.

“The award of this highly competitive training grant reflects recognition of Fordham’s Center for Ethics Education as a national leader in drug abuse and HIV research ethics scholarship and training,” said Fisher, the center’s director. “The grant is a natural extension of the center’s decade of ethics-education and research initiatives.”

The program will start in July with an intensive summer institute. It will be offered to early career scientists in social, behavioral, medical and public health who are experts in HIV-prevention research. Applicants must be able to initiate research on the conduct, improvement and evaluation of population-sensitive HIV prevention research ethical procedures.

It will consist of four cohorts of six trainees each. After the first year, the program will feature:

• a two-year individually mentored and financially supported research pilot project on an ethical issue in HIV prevention research;

• an advanced summer seminar for trainees in their second year focused on data analysis, professional and community dissemination of their mentored research project and grant writing incorporating the mentored project as a pilot study for a grant supplement or new grant;

• access to web-based platform for HIV-prevention ethics resources and collegial exchange; and

• participation in a mini-conference on HIV-prevention research ethics in the fifth year.

HIV is a particularly important area for ethics research, Fisher noted. There are ethical challenges in settings where concepts of autonomy differ from traditional Western values, or are imbalanced when it comes to gender.

This is especially prevalent in developing countries, where women are afflicted with the virus more than men.

“Under what cultural conditions is it morally unacceptable to require male permission for a competent adult woman to participate in an HIV-prevention trial?” she asked. “In such situations, what measures are sufficient to ensure respect for a woman’s autonomy? When does an investigator’s pressure for female autonomy violate a woman’s cultural choices and values?”

Studying couples who are serodiscordant, (one is HIV positive, one is negative) also presents challenges, she said. On the one hand, informed consent procedures require that infected individuals disclose their HIV status to their partners.

But testing the partner, which occurs at the screening stage, presents social and physical risks if the partner also tests positive for HIV. This would exclude the couple from the study (since they both have HIV) and expose their status.

“Investigators need to inform the partner of these potential risks and take steps to minimize the risk,” Fisher said. “They need to consider whether a single or multi-stage consent process at the time of screening is most appropriate for the population that is being studied.”

Although HIV/AIDS is not as prevalent in the United States as it once was, Fisher said that more than 2.5 million adults and children became infected with HIV in 2008. By the end of that year an estimated 33.4 million people worldwide were living with HIV/AIDS.

It was responsible for two million deaths—increasing to 25 million the number of people who have died from AIDS since 1981. The burden of the disease now falls hardest on poor, disempowered, stigmatized populations and marginalized racial/ethnic and tribal groups.

“Through years of experience, seasoned HIV investigators have acquired the knowledge and skills to make significant contributions to HIV ethical practice, but early career HIV scientists have few opportunities for formal research ethics training or ethics consultation with senior colleagues,” Fisher said.

“The proposed program will provide early career HIV prevention scientists with knowledge and skills to ensure the responsible conduct of their own work and to contribute to the advancement of research ethics policy in the field.”

Even though the researcher later explained this to Fisher, it would be
years before she fully understood this research method and got over the
embarrassment it caused her.

This experience, along with her early research with children, drove
Fisher to investigate ethical issues in psychological research, she told an
audience in the William D. Walsh Family Library’s Flom Auditorium on Nov. 12.
Her lecture, “Wisdom, Learning and Justice in Health Care Research,” was part of
the Sapientia et Doctrina lecture series and marked Fisher’s installation as the
Marie Ward Doty Professor of Psychology. She was awarded the Sapientia et
Doctrina medallion for her distinguished scholarship and contributions to ethics
policies for health research and practice.

During her lecture, Fisher said that she entered the field of psychology as “a
warrior in the scientific quest for knowledge,” however, “motherhood stopped me
dead in my Donna Quixote tracks.” While testing infants in studies on visual
perception, she started to wonder if exposing babies to even mild discomforts
was worth the benefits of the research.

“These experiences and other fortuitous professional circumstances drew me
into the field of ethics,” said Fisher, who is also the director of Fordham’s
Center for Ethics Education. She added, “I approached my newfound cause with the
same formalism with which I had pursued scientific knowledge years earlier. I
hoped that through an ethicist’s armory of moral principles and moral
frameworks, one could construct a universal code of research ethics free of
subjective bias.”

Fisher quickly learned that her mission would be fraught with
philosophical dilemmas. She realized that traditional approaches to ethical
decision-making were problematic because they prioritized the reasoning ability
of scientists while ignoring and devaluing the perspectives of research
participants.

“I realized that the best way to truly care for research participants is
to understand their point of view,” she said. “And the best way to understand
their point of view is to ask them.”

Fisher has spent years learning from and providing ethical guidance to
vulnerable communities, such as children, ethnic minorities and adults with
developmental disabilities. Through her research, she has been faced with
questions of moral obligation, including researchers’ responsibility to help
teenagers in trouble and to ensure that their research does not stigmatize a
community.

“I have learned so much from these communities,” she said, referring to
ethnic minorities. “Their views have forced me to question the validity of my
own worldviews and the extent to which my cultural lens may unintentionally harm
or disenfranchise ethnic minority participants.”

Two years ago, Fisher chaired a Fordham Ethics Center-sponsored
conference that, with support from the National Institute of Mental Health and
the American Psychological Association (APA), developed the first published
guidelines for ethical conduct in mental health research involving ethnic
minority children and youth. She has also helped to develop educational tools to
make sure that adults with developmental disabilities understand and can give
informed consent for research and treatment. For five years, Fisher chaired the
APA’S Ethics Code Task Force, which was responsible for revising the Ethical
Principles of Psychologists and Code of Conduct. The code took effect on June 1,
2003. Fisher is currently a member of the Secretary of Health and Human
Services’ Advisory Committee on Human Research Protections.

As the occupant of the Marie Ward Doty Chair, Fisher will continue to lead the
much-needed academic inquiry into the area of ethical research involving a wide
variety of vulnerable populations. The Doty Chair was established in 1980
through a generous endowment by George E. Doty (FCO ’38) in honor of his wife,
Marie.

Fordham University’s motto, Sapientia et Doctrina (Wisdom and Learning),
emphasizes rigorous scholarship and embraces a community of men and women
committed to exploring the life of the mind.  In this spirit, a lecture series
celebrating the inauguration of the 32nd president of Fordham University, Joseph
M. McShane, S.J., was established.

The Sapientia et Doctrina medallion is bestowed upon individuals of
national and international renown who have made substantial contributions to the
advancement of their disciplines and to an understanding of the ideals to which
a Jesuit education summons us.