Title first published in 2003. John Macquarrie has been a major contributor in the theological world for more than forty years, but as yet very little secondary material on his work has appeared. This book offers an insightful introduction to Macquarrie's theology, arguing that at its heart is a systematic theology of gift. Tracing the development of his thought from its early existentialism to the social and world-affirming perspectives of later writings, this book shows how these developments emerge in dialogue (...) with contemporary thinkers. Morley demonstrates how Macquarrie's theology mediates between two traditionally opposing theologies of gift and being, centring on the doctrines of God and of human being, and reaching its fullest expression in Christology, with Christ as the focal point of two personal movements of self-giving - divine and human. Macquarrie himself contributes a Foreword. (shrink)

Professor Willey pursues further his survey of nineteenth century English writing in this critico-biographical analysis of the group of Victorian free-thinkers or liberals, who progressively re-interpreted the Christian faith in the glare of current historical and scientific criticism and gave expression and impetus to the massive loss of faith characteristic of that century. His pen ranges from men of letters and historians to divines, notably from Tennyson, ‘Mark Rutherford’, J. A. Froude and John Morley to the notorious Septem Contra (...) Christum of 1860. He presents his main theme with lucid fairness and graceful scholarship, even with optimism. He regards these honest doubters, not as period-pieces but as live sources for a liberal revival in religion “chastened by twentieth century experience”. And he suggests, doubtless speaking of the intellectual milieu of the official Church of England: “If faith to-day has recovered tone and confidence, it owes this largely to the work of these pioneers who compelled it to abandon many impossible positions”. (shrink)

Background There is ongoing debate regarding how moral distress should be defined. Some scholars argue that the standard “narrow” definition overlooks morally relevant causes of distress, while others argue that broadening the definition of moral distress risks making measurement impractical. However, without measurement, the true extent of moral distress remains unknown. Research aims To explore the frequency and intensity of five sub-categorizations of moral distress, resources used, intention to leave, and turnover of nurses using a new survey instrument. Research design (...) A mixed methods embedded design included a longitudinal, descriptive investigator-developed electronic survey with open-ended questions sent twice a week for 6 weeks. Analysis included descriptive and comparative statistics and content analysis of narrative data. Participants Registered nurses from four hospitals within one large healthcare system in Midwest United States. Ethical considerations IRB approval was obtained. Results 246 participants completed the baseline survey, 80 participants provided data longitudinally for a minimum of 3 data points. At baseline, moral-conflict distress occurred with the highest frequency, followed by moral-constraint distress and moral-tension distress. By intensity, the most distressing sub-category was moral-tension distress, followed by “other” distress and moral-constraint distress. Longitudinally, when ranked by frequency, nurses experienced moral-conflict distress, moral-constraint distress, and moral-tension distress; by intensity, scores were highest for moral-tension distress, moral-uncertainty distress, and moral-constraint distress. Of available resources, participants spoke with colleagues and senior colleagues more frequently than using consultative services such as ethics consultation. Conclusions Nurses experienced distress related to a number of moral issues extending beyond the traditional understanding of moral distress (as occurring due to a constraint) suggesting that our understanding and measurement of moral distress should be broadened. Nurses frequently used peer support as their primary resource but it was only moderately helpful. Effective peer support for moral distress could be impactful. Future research on moral distress sub-categories is needed. (shrink)

In recent years, the phenomenon of moral distress has been critically examined—and for a good reason. There have been a number of different definitions suggested, some that claimed to be consistent with the original definition but in fact referred to different epistemological states. In this paper, we re‐examine moral distress by exploring its relationship with moral agency. We critically examine three conceptions of moral agency and argue that two of these conceptions risk placing nurses' values at the center of moral (...) action when it ought to be the patient's values that shape nurses' obligations. We propose that the conception of moral agency advanced by Aimee Milliken which re‐centers patient values, should be more broadly accepted within nursing. We utilize a case example to demonstrate a situation in which the values of a patient's parents (surrogates) justifiably constrained nurses' moral agency, creating moral distress. Through an examination of constraints on nurse agency in this case, we illustrate the problematic nature of ‘narrow' moral distress and the value of re‐considering moral distress. Finally, we provide an action‐oriented proposal identifying mediating steps that we argue have utility for nurses (and other healthcare professionals) to mediate between experiences of narrow moral distress and the exercise of moral agency. (shrink)

The debate about the ethical implications of Artificial Intelligence dates from the 1960s :741–742, 1960; Wiener in Cybernetics: or control and communication in the animal and the machine, MIT Press, New York, 1961). However, in recent years symbolic AI has been complemented and sometimes replaced by Neural Networks and Machine Learning techniques. This has vastly increased its potential utility and impact on society, with the consequence that the ethical debate has gone mainstream. Such a debate has primarily focused on principles—the (...) ‘what’ of AI ethics —rather than on practices, the ‘how.’ Awareness of the potential issues is increasing at a fast rate, but the AI community’s ability to take action to mitigate the associated risks is still at its infancy. Our intention in presenting this research is to contribute to closing the gap between principles and practices by constructing a typology that may help practically-minded developers apply ethics at each stage of the Machine Learning development pipeline, and to signal to researchers where further work is needed. The focus is exclusively on Machine Learning, but it is hoped that the results of this research may be easily applicable to other branches of AI. The article outlines the research method for creating this typology, the initial findings, and provides a summary of future research needs. (shrink)

The precipitous cliffs, rolling headlands, and rocky inlets of the Big Sur coast of California prompted Robinson Jeffers to extol their wild beauty throughout his long career as a poet. This extraordinary volume brings together Jeffers’s haunting poetry with magnificent photographs of Big Sur by his friend and neighbor, famed photographer Morley Baer.

As the range of potential uses for Artificial Intelligence, in particular machine learning, has increased, so has awareness of the associated ethical issues. This increased awareness has led to the realisation that existing legislation and regulation provides insufficient protection to individuals, groups, society, and the environment from AI harms. In response to this realisation, there has been a proliferation of principle-based ethics codes, guidelines and frameworks. However, it has become increasingly clear that a significant gap exists between the theory of (...) AI ethics principles and the practical design of AI systems. In previous work, we analysed whether it is possible to close this gap between the ‘what’ and the ‘how’ of AI ethics through the use of tools and methods designed to help AI developers, engineers, and designers translate principles into practice. We concluded that this method of closure is currently ineffective as almost all existing translational tools and methods are either too flexible or too strict. This raised the question: if, even with technical guidance, AI ethics is challenging to embed in the process of algorithmic design, is the entire pro-ethical design endeavour rendered futile? And, if no, then how can AI ethics be made useful for AI practitioners? This is the question we seek to address here by exploring why principles and technical translational tools are still needed even if they are limited, and how these limitations can be potentially overcome by providing theoretical grounding of a concept that has been termed ‘Ethics as a Service.’. (shrink)

Austerity, by its very nature, imposes constraints by limiting the options for action available to us because certain courses of action are too costly or insufficiently cost effective. In the context of healthcare, the constraints imposed by austerity come in various forms; ranging from the availability of certain treatments being reduced or withdrawn completely, to reductions in staffing that mean healthcare professionals must ration the time they make available to each patient. As austerity has taken hold, across the United Kingdom (...) and Europe, it is important to consider the wider effects of the constraints that it imposes in healthcare. Within this paper, we focus specifically on one theorised effect—moral distress. We differentiate between avoidable and unavoidable ethical challenges within healthcare and argue that austerity creates additional avoidable ethical problems that exacerbate clinicians’ moral distress. We suggest that moral resilience is a suitable response to clinician moral distress caused by unavoidable ethical challenges but additional responses are required to address those that are created due to austerity. We encourage clinicians to engage in critical resilience and activism to address problems created by austerity and we highlight the responsibility of institutions to support healthcare professionals in such challenging times. (shrink)

Technologies to rapidly alert people when they have been in contact with someone carrying the coronavirus SARS-CoV-2 are part of a strategy to bring the pandemic under control. Currently, at least 47 contact-tracing apps are available globally. They are already in use in Australia, South Korea and Singapore, for instance. And many other governments are testing or considering them. Here we set out 16 questions to assess whether — and to what extent — a contact-tracing app is ethically justifiable.

The Covid‐19 pandemic has highlighted many of the difficult ethical issues that health care professionals confront in caring for patients and families. The decisions such workers face on the front lines are fraught with uncertainty for all stakeholders. Our focus is on the implications for nurses, who are the largest global health care workforce but whose perspectives are not always fully considered. This essay discusses three overarching ethical issues that create a myriad of concerns and will likely affect nurses globally (...) in unique ways: the safety of nurses, patients, colleagues, and families; the allocation of scarce resources; and the changing nature of nurses’ relationships with patients and families. We urge policy‐makers to ensure that nurses’ voices and perspectives are integrated into both local and global decision‐making so as to minimize the structural injustices many nurses have faced to date. Finally, we urge nurses to seek sources of support throughout this pandemic. (shrink)

By mid-2019 there were more than 80 AI ethics guides available in the public domain. Despite this, 2020 saw numerous news stories break related to ethically questionable uses of AI. In part, this is because AI ethics theory remains highly abstract, and of limited practical applicability to those actually responsible for designing algorithms and AI systems. Our previous research sought to start closing this gap between the ‘what’ and the ‘how’ of AI ethics through the creation of a searchable typology (...) of tools and methods designed to translate between the five most common AI ethics principles and implementable design practices. Whilst a useful starting point, that research rested on the assumption that _all_ AI practitioners are aware of the ethical implications of AI, understand their importance, and are actively seeking to respond to them. In reality, it is unclear whether this is the case. It is this limitation that we seek to overcome here by conducting a mixed-methods qualitative analysis to answer the following four questions: what do AI practitioners understand about the need to translate ethical principles into practice? What motivates AI practitioners to embed ethical principles into design practices? What barriers do AI practitioners face when attempting to translate ethical principles into practice? And finally, what assistance do AI practitioners want and need when translating ethical principles into practice? (shrink)

This article highlights the limitations of the tendency to frame health- and wellbeing-related digital tools (mHealth technologies) as empowering devices, especially as they play an increasingly important role in the National Health Service (NHS) in the UK. It argues that mHealth technologies should instead be framed as digital companions. This shift from empowerment to companionship is advocated by showing the conceptual, ethical, and methodological issues challenging the narrative of empowerment, and by arguing that such challenges, as well as the risk (...) of medical paternalism, can be overcome by focusing on the potential for mHealth tools to mediate the relationship between recipients of clinical advice and givers of clinical advice, in ways that allow for contextual flexibility in the balance between patiency and agency. The article concludes by stressing that reframing the narrative cannot be the only means for avoiding harm caused to the NHS as a healthcare system by the introduction of mHealth tools. Future discussion will be needed on the overarching role of responsible design. (shrink)

Aims: The aim of this narrative synthesis was to explore the necessary and sufficient conditions required to define moral distress. Background: Moral distress is said to occur when one has made a moral judgement but is unable to act upon it. However, problems with this narrow conception have led to multiple redefinitions in the empirical and conceptual literature. As a consequence, much of the research exploring moral distress has lacked conceptual clarity, complicating attempts to study the phenomenon. Design: Systematic literature (...) review and narrative synthesis (November 2015–March 2016). Data sources: Ovid MEDLINE® In-Process & Other Non-Indexed Citations 1946–Present, PsycINFO® 1967–Present, CINAHL® Plus 1937–Present, EMBASE 1974–24 February 2016, British Nursing Index 1994–Present, Social Care Online, Social Policy and Practice Database (1890–Present), ERIC (EBSCO) 1966–Present and Education Abstracts. Review methods: Literature relating to moral distress was systematically retrieved and subjected to relevance assessment. Narrative synthesis was the overarching framework that guided quality assessment, data analysis and synthesis. Results: In all, 152 papers underwent initial data extraction and 34 were chosen for inclusion in the narrative synthesis based on both quality and relevance. Analysis revealed different proposed conditions for the occurrence of moral distress: moral judgement, psychological and physical effects, moral dilemmas, moral uncertainty, external and internal constraints and threats to moral integrity. Conclusion: We suggest the combination of (1) the experience of a moral event, (2) the experience of ‘psychological distress’ and (3) a direct causal relation between (1) and (2) together are necessary and sufficient conditions for moral distress. (shrink)

The World Health Organisation declared COVID-19 a global pandemic on 11th March 2020, recognising that the underlying SARS-CoV-2 has caused the greatest global crisis since World War II. In this chapter, we present a framework to evaluate whether and to what extent the use of digital systems that track and/or trace potentially infected individuals is not only legal but also ethical.

Newcomers and more experienced feminist theorists will welcome this even-handed survey of the care/justice debate within feminist ethics. Grace Clement clarifies the key terms, examines the arguments and assumptions of all sides to the debate, and explores the broader implications for both practical and applied ethics. Readers will appreciate her generous treatment of the feminine, feminist, and justice-based perspectives that have dominated the debate.Clement also goes well beyond description and criticism, advancing the discussion through the incorporation of a broad (...) range of insights into a new integration of the values of care and justice. Care, Autonomy, and Justice marks a major step forward in our understanding of feminist ethics. It is both direct and helpful enough to work as an introduction for students and insightful and original enough to make it necessary reading for scholars. (shrink)

While Jameton’s (1984) definition of moral distress has been embraced by researchers and scholars for recognizing the many constraints that nurses experience on their moral agency, it has also been...

Background: Nurses face ethical issues and experience moral distress in their everyday work. A nursing ethics champion program was developed at a hospital in the United States. Methods: As part of a quality improvement project, pre- and post-training surveys were developed to assess whether the program was feasible and sustainable, enhanced nurse confidence in recognizing and addressing ethical issues and moral distress, and increased nurse knowledge of institutional resources for addressing the same. Qualitative and quantitative analyses were performed. Results: Thirteen (...) nurses from both the critical care and medical/surgical settings participated in the program. The program proved feasible. Attrition after the educational sessions raised concerns about sustainability. Survey results suggest an association between participating in the program’s educational sessions and increased nurse confidence in recognizing and addressing ethical issues and moral distress, as well as identifying institutional resources that can assist nurses with the same. Discussion: Opportunities for future nursing ethics champion programs include increasing the interactivity and duration of educational sessions, making programs multidisciplinary, and creating materials for nurses to more easily share with colleagues. It would be valuable for future research to measure the impact of nursing ethics champion programs on nursing turnover. Implications: A nursing ethics champion program has the potential to help nurses feel better equipped to navigate ethical issues and moral distress in their everyday work. (shrink)

Within this paper, we discuss Moral Distress Reflective Debriefs as a promising approach to address and mitigate moral distress experienced by healthcare professionals. We briefly review the empirical and theoretical literature on critical incident stress debriefing and psychological debriefing to highlight the potential benefits of this modality. We then describe the approach that we take to facilitating reflective group discussions in response to morally distressing patient cases (“Moral Distress Reflective Debriefs”). We discuss how the debriefing literature and other clinical ethics (...) activities influenced the development of our approach. In particular, we focus on the role of the clinical ethicist as a facilitator with particular emphasis on encouraging perspective-taking and nurturing ethical attunement in a supportive manner. We suggest that this approach reduces the narrowing effects of frustration and anger that are often reported when individuals experience moral-constraint distress. Finally, we provide an example of Moral Distress Reflective Debriefs, elucidating how this supportive process complements ethics consultation and can mitigate the negative effects of moral distress. (shrink)

The idea of a role in nursing that includes expertise in ethics has been around for more than 30 years. Whether or not one subscribes to the idea that nursing ethics is separate and distinct from bioethics, nursing practice has much to contribute to the ethical practice of healthcare, and with the strong grounding in ethics and aspiration for social justice considerations in nursing, there is no wonder that the specific role of the nurse ethicist has emerged. Nurse ethicists, expert (...) in nursing practice and the application of ethical theories and concepts, are well positioned to guide nurses through complex ethical challenges. However, there is limited discussion within the field regarding the specific job responsibilities that the nurse ethicist ought to have. The recent appearance of job postings with the title “nurse ethicist” suggest that some healthcare institutions have identified the value of a nurse in the practice of ethics and are actively recruiting. Discomfort about the possibility of others defining the role of the nurse ethicist inspired this paper (and special issue). If the nurse ethicist is to be seen as an integral part of addressing ethical dilemmas and ethical conflicts that arise in healthcare, then nurse ethicists ought to be at the forefront of defining this role. In this paper, we draw upon our own experiences as nurse ethicists in large academic healthcare systems to describe the essential elements that ought to be addressed in a job description for a nurse ethicist practicing in a clinical setting linked to academic programs. Drawing upon our experience and the literature, we describe how we perceive the nurse ethicist adds value to healthcare organizations and teams of professional ethicists. (shrink)

By far the largest part of Nehemiah Grew?s account of a seventeenth?century collection of rarities, his Musæum Regalis Societatis (1685) is taken up with ?thick?, verbal descriptions of things in the Royal Society?s repository. Not only, Grew suggests, do his descriptions serve to signify the contents of his collection, but they enable us to discern among species and to think about the collection?s pieces in new ways. Verbal descriptions did not just signify things in the Royal Society?s collection, but had (...) the capacity to alter their meanings. The essay discusses the ?picturing? of natural things in Early Modern Europe with little direct reference to the contemporary media of graphic representation ? drawings, engravings, paintings etc. ? in order to highlight the role of the then most widely used, but now least discussed of these media, verbal descriptions. (shrink)

The great increase of interest in the study of spirituality and mysticism is reflected in the large number of articles that the Encyclopedia of Religion devotes to various aspects of this topic. As one would expect, there are long entries for ‘Mysticism’ and ‘Christian Spirituality’ and ‘Religious Experience’. In addition to these broad categories, attention is given to more specific aspects of spirituality such as ‘Asceticism’, ‘Silence’, ‘Prayer’, ‘Meditation’, and so on. This is complemented by entries on many of the (...) spiritual giants of the Christian tradition, both ancient and modern. I shall begin by discussing these articles on individuals, and go on to examine the more general articles later in the review. I shall suggest that, despite many merits, both sorts of entry display an editorial policy about which serious questions must be raised. (shrink)

Most attempts at forecasting the future depend, explicitly or implicitly, on knowledge about the past, whether this is then used to offer possible analogies or to support normative theories with data about past events and trends. This approach is open to criticism both on the grounds of its assumptions about continuity and a tendency toward deterministic thinking and on the grounds that our knowledge of the past is less secure and more discursive than such attempts at prediction assume. Counterfactualism, the (...) development and exploration of accounts of “what might have been” – which can be focused on obtaining better understanding of the past, or on refining theories of the present, or on speculations about the future – offers an alternative approach that emphasizes the openness of historical developments. Its primary role is not to improve forecasting but to highlight its limitations, to expand our knowledge of how humans think about the future and the cognitive biases that dominate such thinking, and to establish the ethical imperative of engaging with possible futures. The qualities which make counterfactualism a marginal and suspect activity within historiography and social science are precisely those which make it an essential aspect of the discipline of anticipation. (shrink)

This article seeks to explicate one form of technical rationality (ie the technological development of robotics) in social work education and practice. As advances in robotics evolve, questions are raised about the role of technicist education in reducing social work practice to a set of tasks that are repeatable, formulaic and linear (ie tasks that robots are capable of performing). We conduct a critical synthesis of the literature to explore how these parallel processes potentially create a seamless transition for social (...) robots to replace the human social work workforce. Our analysis suggests that social workers need to reclaim a broader understanding of social work education and practice if we intend to retain human social work practitioners into the future. We argue that this is vital because critical social work practitioners are more capable than robots of meeting the espoused social justice values of social work. (shrink)

Background The phenomenon of ‘moral distress’ has continued to be a popular topic for nursing research. However, much of the scholarship has lacked conceptual clarity, and there is debate about what it means to experience moral distress. Moral distress remains an obscure concept to many clinical nurses, especially those outside of North America, and there is a lack of empirical research regarding its impact on nurses in the United Kingdom and its relevance to clinical practice. Research aim To explore the (...) concept of moral distress in nursing both empirically and conceptually. Methodology Feminist interpretive phenomenology was used to explore and analyse the experiences of critical care nurses at two acute care trauma hospitals in the United Kingdom. Empirical data were analysed using Van Manen’s six steps for data analysis. Ethical considerations The study was approved locally by the university ethics review committee and nationally by the Health Research Authority in the United Kingdom. Findings The empirical findings suggest that psychological distress can occur in response to a variety of moral events. The moral events identified as causing psychological distress in the participants’ narratives were moral tension, moral uncertainty, moral constraint, moral conflict and moral dilemmas. Discussion We suggest a new definition of moral distress which captures this broader range of moral events as legitimate causes of distress. We also suggest that moral distress can be sub-categroised according to the source of distress, for example, ‘moral-uncertainty distress’. We argue that this could aid in the development of interventions which attempt to address and mitigate moral distress. Conclusion The empirical findings support the notion that narrow conceptions of moral distress fail to capture the real-life experiences of this group of critical care nurses. If these experiences resonate with other nurses and healthcare professionals, then it is likely that the definition needs to be broadened to recognise these experiences as ‘moral distress’. (shrink)

This paper presents the place of dreaming in Merleau-Ponty’s thought. It elicits the view of dreaming developed in three seminal texts:Phenomenology of Perception, the passivity fragment from the Themes from the Lectures at the College de France, and The Visible and the Invisible. In each of these texts, Merleau-Ponty releases dreaming from the secondary status conventionally granted to it in relation to waking perception, and maintains, instead, the integrity of the phenomenon as an authentic mode of experience. At the same (...) time, he insists upon the interrelatedness of dreaming and waking by positing for both the lived body as a common ground that precludes dichotomization. Merleau-Ponty’s elevation of the imaginary in general, and dreaming in particular, is especially relevant to contemporary psychology in its quest for theoretical foundations that will accommodate the full spectrum of psychological phenomena. (shrink)

There has been increasing debate in recent years about the conceptualization of moral distress. Broadly speaking, two groups of scholars have emerged: those who agree with Jameton’s ‘narrow definition’ that focuses on constraint and those who argue that Jameton’s definition is insufficient and needs to be broadened. Using feminist empirical bioethics, we interviewed critical care nurses in the United Kingdom about their experiences and conceptualizations of moral distress. We provide our broader definition of moral distress and examples of data that (...) both challenge and support our conceptualization. We pre‐empt and overcome three key challenges that could be levelled at our account and argue that there are good reasons to adopt our broader definition of moral distress when exploring prevalence of, and management strategies for, moral distress. (shrink)

In this essay, I examine Robert Boyle's strategies for making imperceptible entities accessible to the senses. It is well known that, in his natural philosophy, Boyle confronted the challenge of making imperceptible particles of matter into objects of sensory experience. It has never been noted, however, that Boyle confronted a strikingly similar challenge in his natural theology – he needed to make an equally imperceptible God accessible to the senses. Taking this symmetrical difficulty as my starting point, I propose a (...) new approach to thinking about the interconnections between Boyle's natural philosophy and natural theology. For the most part, studies of science and religion in the early modern period work by seeking out the influence of explicitly stated religious beliefs on scientific ideas. I argue, by contrast, that we need to focus on Boyle's representational practices, using his attempts to represent imperceptible entities as a means of uncovering metaphysical and theological presuppositions that he did not always articulate when stating his religious beliefs. With new interpretations of bothA Discourse of Things Above Reason(1681) andSome Physico-Theological Considerations about the Possibility of the Resurrection(1675), I show that there were crucial similarities between Boyle's practices for representing both God and atoms. I go on to show, moreover, that Boyle used these practices to enact an ontological stance at odds with one of his most important professed beliefs. (shrink)

This paper provides an account of anonymous speech treated as anonymized speech. It is argued that anonymous speech acts are best defined by reference to intentional acts of blocking a speaker's identification as opposed to the various epistemic effects that imperfectly correlate with these actions. The account is used to examine two important subclasses of anonymized speech: speech using pseudonyms, and speech anonymized in a specifically communicative manner. Several pragmatic and ethical issues with anonymized speech are considered.

"The book’s contribution to feminist philosophy of religion is substantial and original.... It brings the continental and Anglo-American traditions into substantive and productive conversation with each other." —Ellen Armour To what extent has the emergence of the study of religion in Western culture been gendered? In this exciting book, Grace Jantzen proposes a new philosophy of religion from a feminist perspective. Hers is a vital and significant contribution which will be essential reading in the study of religion.

Healthcare systems across the globe are struggling with increasing costs and worsening outcomes. This presents those responsible for overseeing healthcare with a challenge. Increasingly, policymakers, politicians, clinical entrepreneurs and computer and data scientists argue that a key part of the solution will be ‘Artificial Intelligence’ (AI) – particularly Machine Learning (ML). This argument stems not from the belief that all healthcare needs will soon be taken care of by “robot doctors.” Instead, it is an argument that rests on the classic (...) counterfactual definition of AI as an umbrella term for a range of techniques that can be used to make machines complete tasks in a way that would be considered intelligent were they to be completed by a human. Automation of this nature could offer great opportunities for the improvement of healthcare services and ultimately patients’ health by significantly improving human clinical capabilities in diagnosis, drug discovery, epidemiology, personalised medicine, and operational efficiency. However, if these AI solutions are to be embedded in clinical practice, then at least three issues need to be considered: the technical possibilities and limitations; the ethical, regulatory and legal framework; and the governance framework. In this article, we report on the results of a systematic analysis designed to provide a clear overview of the second of these elements: the ethical, regulatory and legal framework. We find that ethical issues arise at six levels of abstraction (individual, interpersonal, group, institutional, sectoral, and societal) and can be categorised as epistemic, normative, or overarching. We conclude by stressing how important it is that the ethical challenges raised by implementing AI in healthcare settings are tackled proactively rather than reactively and map the key considerations for policymakers to each of the ethical concerns highlighted. (shrink)

While the phenomenon of ‘moral distress’ has been of interest to the nursing community since Jameton first described it in 1984, moral distress is now understood to effect healthcare professionals...

This paper concerns sock puppetry, a practice which involves an individual communicating under multiple pseudonymous identities in a manner that makes it seem as though these personas are distinct conversational participants. I provide a definition of sock puppetry that is more narrow than other definitions, allowing it to be distinguished from related phenomena. I then analyse some of the ways in which sock puppetry can interfere with social tools we use for establishing trust within an online community, evaluating a speaker's (...) credibility, and generally deciding who and what to believe. (shrink)

This is an EXACT reproduction of a book published before 1923.