Placebo Effects and Informed Consent.

The concepts of placebos and placebo effects refer to extremely diverse phenomena. I recommend dissolving the concepts of placebos and placebo effects into loosely related groups of specific mechanisms, including (potentially among others) expectation-fulfillment, classical conditioning, and attentional-somatic feedback loops. If this approach is on the right track, it has three main implications for the ethics of informed consent. First, because of the expectation-fulfillment mechanism, the process of informing cannot be considered independently from the potential effects of treatment. Obtaining informed consent influences the effects of treatment. This provides support for the authorized concealment and authorized deception paradigms, and perhaps even for outright deceptive placebo use. Second, doctors may easily fail to consider the potential benefits of conditioning, leading them to misjudge the trade-off between beneficence and autonomy. Third, how attentional-somatic feedback loops play out depends not only on the content of the informing process but also on its framing. This suggests a role for libertarian paternalism in clinical practice.

El uso de sonidos como estímulos en el condicionamiento clásico electrodérmico humano / The use of sounds as stimuli in human electrodermal classical conditioning

Tradicionalmente, en el estudio del condicionamiento clásico humano se emplearon descargas eléctricas y ruidos intensos como estímulos incondicionados aversivos. Sin embargo, el uso de este tipo de estímulos plantea una serie de problemas de carácter ético y metodológico. Consecuentemente, en trabajos recientes se comprobó que podía obtenerse condicionamiento sustituyendo el habitual ruido blanco por un sonido cuya aversividad se derivaba más de su contenido semántico que de su intensidad. Sin embargo, los estímulos empleados en estos trabajos plantean, a su vez, una serie de problemas relacionados tanto con la complejidad técnica requerida para su grabación y posterior edición como con la replicación de los resultados. En este estudio se pretende superar dichos problemas utilizando sonidos del IADS ("International Affective Digitized Sounds") como estímulos condicionados e incondicionados en un procedimiento de condicionamiento clásico electrodérmico. Los resultados mostraron una rápida disminución en la amplitud de las respuestas que se interpretó en términos de una habituación de la reacción de orientación. Se comentan las limitaciones encontradas y se propone la posibilidad de utilizar la metodología empleada en este estudio en futuros trabajos (AU)

Traditionally, human classical conditioning studies used electric shocks and loud noises as aversive unconditioned stimuli. However, the use of such stimuli raises a number of methodological and ethical issues. Consequently, in recent works it was found that conditioning could be obtained by replacing the usual white noise with a sound whose aversivity could be derived from its semantic content rather than its intensity. However, the stimuli used in these studies raise, in turn, a number of problems related to both technical complexity required for recording and further editing as difficulties in replication of the results. The present work suggests the possibility of overcoming these problems using sounds selected from the IADS (International Affective Digitized Sounds) as conditioned and unconditioned stimuli on electrodermal classical conditioning procedure. The results showed a rapid decrease in the amplitude of the responses that was interpreted in terms of a habituation of the orienting reaction. We discuss the limitations found, and propose the possibility of using the methodological approach employed in this study in future work (AU)

Mechanisms of Contextual Control when Contexts are Informative to Solve the Task

An experiment was conducted using a human instrumental learning task with the goal of evaluating the mechanisms underlying the deleterious effect of context-switching on responding to an unambiguous stimulus when contexts are informative to solve the task. Participants were trained in a context-based reversal discrimination in which two discriminative stimuli (X and Y) interchange their meaning across contexts A and B. In context A, discriminative stimulus Z consistently announced that the relationship between a specific instrumental response (R1) and a specific outcome (O1) was in effect. Performance in the presence of stimulus Z was equally deteriorated when the test was conducted outside the training context, regardless of whether the test context was familiar (context B) or new (context C). This result is consistent with the idea that participants code all the information presented in an informative context as context-specific with the context playing a role akin to an occasion setter (AU)

Se realizó un experimento en condicionamiento instrumental humano con el objetivo de evaluar los mecanismos subyacentes al efecto de cambio de contexto sobre una clave de significado no ambiguo cuando los contextos son informativos para solucionar la tarea. Se entrenó a los participantes en una discriminación inversa basada en el contexto en la que debían discriminar entre dos claves (X e Y) que intercambiaban sus significados entre los contextos A y B. En el contexto A se presentó además el estímulo discriminativo Z anunciando consistentemente una relación entre una respuesta instrumental concreta (R1) y una consecuencia determinada (O1). La respuesta en presencia de la clave Z durante la prueba empeoró cuando la prueba se realizó fuera del contexto de entrenamiento, independientemente de si el contexto de prueba era un contexto familiar para el participante (contexto B) o un contexto nuevo (contexto C). Estos resultados son consistentes con la idea de que los participantes codifican toda la información presentada en contextos informativos como dependiente de contexto, con el contexto jugando un papel similar al de un estímulo modulador (AU)

The role of moral utility in decision making: an interdisciplinary framework.

What decisions should we make? Moral values, rules, and virtues provide standards for morally acceptable decisions, without prescribing how we should reach them. However, moral theories do assume that we are, at least in principle, capable of making the right decisions. Consequently, an empirical investigation of the methods and resources we use for making moral decisions becomes relevant. We consider theoretical parallels of economic decision theory and moral utilitarianism and suggest that moral decision making may tap into mechanisms and processes that have originally evolved for nonmoral decision making. For example, the computation of reward value occurs through the combination of probability and magnitude; similar computation might also be used for determining utilitarian moral value. Both nonmoral and moral decisions may resort to intuitions and heuristics. Learning mechanisms implicated in the assignment of reward value to stimuli, actions, and outcomes may also enable us to determine moral value and assign it to stimuli, actions, and outcomes. In conclusion, we suggest that moral capabilities can employ and benefit from a variety of nonmoral decision-making and learning mechanisms.