BackgroundArtificial intelligence has been described as the “fourth industrial revolution” with transformative and global implications, including in healthcare, public health, and global health. AI approaches hold promise for improving health systems worldwide, as well as individual and population health outcomes. While AI may have potential for advancing health equity within and between countries, we must consider the ethical implications of its deployment in order to mitigate its potential harms, particularly for the most vulnerable. This scoping review addresses the following question: (...) What ethical issues have been identified in relation to AI in the field of health, including from a global health perspective?MethodsEight electronic databases were searched for peer reviewed and grey literature published before April 2018 using the concepts of health, ethics, and AI, and their related terms. Records were independently screened by two reviewers and were included if they reported on AI in relation to health and ethics and were written in the English language. Data was charted on a piloted data charting form, and a descriptive and thematic analysis was performed.ResultsUpon reviewing 12,722 articles, 103 met the predetermined inclusion criteria. The literature was primarily focused on the ethics of AI in health care, particularly on carer robots, diagnostics, and precision medicine, but was largely silent on ethics of AI in public and population health. The literature highlighted a number of common ethical concerns related to privacy, trust, accountability and responsibility, and bias. Largely missing from the literature was the ethics of AI in global health, particularly in the context of low- and middle-income countries.ConclusionsThe ethical issues surrounding AI in the field of health are both vast and complex. While AI holds the potential to improve health and health systems, our analysis suggests that its introduction should be approached with cautious optimism. The dearth of literature on the ethics of AI within LMICs, as well as in public health, also points to a critical need for further research into the ethical implications of AI within both global and public health, to ensure that its development and implementation is ethical for everyone, everywhere. (shrink)

Introduction -- From paideia to humanism -- Pietism and the problem of human craft (Menschen-Kunst) -- The harmonious harp-playing of humanity: J. G. Herder -- Ethical formation and the invention of the religion of art -- The rise of the Bildungsroman and the commodification of literature -- Authorship and its resignation in Goethe's Wilhelm Meister -- "The Bildung of self-consciousness itself towards science": Hegel.

Truth, Trust and Medicine investigates the notion of trust and honesty in medicine, and questions whether honesty and openness are of equal importance in maintaining the trust necessary in doctor-patient relationships. Jackson begins with the premise that those in the medical profession have a basic duty to be worthy of the trust their patients place in them. Yet questions of the ethics of withholding information and consent and covert surveillance in care units persist. This book boldly addresses these questions which (...) disturb our very modern notions of a patient's autonomy, self-determination and informed consent. (shrink)

I present a view of activity, taking it that an agent is engaged in activity so long as an action of hers is occurring. I suggest that this view (a) helps in understanding what goes wrong in an argument in Thompson (2008) known sometimes as the ‘initial segment argument’, and (b) enables us to see that there could be an intelligible conception of what is basic when agents' knowledge is allowed into an account of that.

This paper applies a relational and familial ethic to address concerns relating to nursing home deaths and advance care planning during Covid‐19 and beyond. The deaths of our elderly in nursing homes during this pandemic have been made more complicated by the restriction of visitors even at the end of life, a time when families would normally be present. While we must be vigilant about preventing unnecessary deaths caused by coronavirus outbreaks in nursing homes, some deaths of our elders are (...) inevitable. Thus, it is essential that advanced care planning occurs in a way that upholds the familial and relational aspects of elders’ lives that often matter to them the most. We invoke concepts from feminist ethicists like Hilde Lindemann and Eva Kittay and introduce Avery Weisman and Thomas Hackett’s concept of “appropriate death” to suggest better ways of planning for those deaths of our elderly that cannot be avoided. Our hope is to allow for deaths that are as meaningful as possible for both the elderly and the family members who survive them. (shrink)

Without proper recognition of the dual pandemics of COVID-19 and racism that Asian Americans and other racial minorities in the United States are facing, we cannot successfully address structural b...

This paper describes the unique values of, challenges within, and opportunities presented by embedded ELSI ethnography. Drawing from our six‐year embedded ELSI study of the WISDOM (Women Informed to Screen Depending on Measures of Risk) trial, we present three examples of the variable ways we engaged with the WISDOM trial's scientific team. WISDOM is a preference‐sensitive, pragmatic, randomized controlled trial of risk‐based breast cancer screening informed by genomics. Our embedded ELSI approach included multiple modes of engagement: (a) Trial investigators sought (...) bioethics expertise; for example, we were asked to consult on traditional bioethics topics such as consent as well as more complex questions about whether to implement a specific risk‐assessment approach on only one race‐defined group of trial participants. (b) As the ELSI investigators, we identified ethical concerns in issues that surfaced via ethnography and considered them in the Bioethics Working Group; for example, there were concerns about the implementation processes that the WISDOM team viewed as logistical challenges. (c) Our presence in WISDOM working group conversations and our expertise on classic social science topics, including race and gender, offered opportunities to engage on the spot with topics such as how to include transgender participants in a trial initially focused on “women's health”; through such engagement, the value of social science became clear to the trial investigators. The paper elaborates on the dynamic relationship between our ethnographic observations, the Bioethics Working Group discussions, and the contributions of each to our real‐time ELSI interventions in these examples. The methods and experiences we describe here suggest modes of engagement that, in combination, have the potential to expand the role of ELSI to offer real‐time intervention on issues related to equity, inclusion, and justice in genetic and genomic research. (shrink)

Order of information plays a crucial role in the process of updating beliefs across time. In fact, the presence of order effects makes a classical or Bayesian approach to inference difficult. As a result, the existing models of inference, such as the belief-adjustment model, merely provide an ad hoc explanation for these effects. We postulate a quantum inference model for order effects based on the axiomatic principles of quantum probability theory. The quantum inference model explains order effects by transforming a (...) state vector with different sequences of operators for different orderings of information. We demonstrate this process by fitting the quantum model to data collected in a medical diagnostic task and a jury decision-making task. To further test the quantum inference model, a new jury decision-making experiment is developed. Using the results of this experiment, we compare the quantum inference model with two versions of the belief-adjustment model, the adding model and the averaging model. We show that both the quantum model and the adding model provide good fits to the data. To distinguish the quantum model from the adding model, we develop a new experiment involving extreme evidence. The results from this new experiment suggest that the adding model faces limitations when accounting for tasks involving extreme evidence, whereas the quantum inference model does not. Ultimately, we argue that the quantum model provides a more coherent account for order effects that was not possible before. (shrink)

Like more than two hundred thousand other Americans, George Floyd howled horribly for air before his death. But his breathlessness was not born from a virus. He was murdered with the burden of anti...

To demonstrate that a fallacy is committed, Block needs to convince us of two things: first, that the concept of phenomenal consciousness is distinct from that of access consciousness, and second, that it picks out a different property from that of access consciousness. I raise doubt about both of these claims, suggesting that the concept of a phenomenal property is the concept of a property to which we have a special sort of access.

En 1997, Hong Kong volvió a China en el marco de la gobernanza conocida como «Un país, dos sistemas», que fue ideado para permitir a la China continental seguir siendo «socialista», mientras Hong Kong podía mantener su sistema capitalista. Sin embargo, la estrategia retórica y legal de mantener metafórica y constitucionalmente la distancia entre los dos lugares y seguir afirmando su soberanía y unidad, es ambigua y contradictoria. Este artículo explora estas ambiguas contradicciones (estratégicas, ideológicas y retóricas) y tras ello (...) su impacto en el debate sobre la democracia y el sufragio en Hong Kong, que su constitución, la Ley básica, promete para el futuro. (shrink)

Adherens (AJ) and tight junctions (TJ) maintain cell‐cell adhesions and cellular polarity in normal tissues. Afadin, a multi‐domain scaffold protein, is commonly found in both adherens and tight junctions, where it plays both structural and signal‐modulating roles. Afadin is a complex modulator of cellular processes implicated in cancer progression, including signal transduction, migration, invasion, and apoptosis. In keeping with the complexities associated with the roles of adherens and tight junctions in cancer, afadin exhibits both tumor suppressive and pro‐metastatic functions. In (...) this review, we will explore the dichotomous roles that afadin plays during cancer progression. (shrink)

Book synopsis: The aim of this collection of papers is to present different philosophical perspectives on the mental, exploring questions about how to define, explain and understand the various kinds of mental acts and processes, and exhibiting, in particular, the contrast between naturalistic and non-naturalistic approaches. There is a long tradition in philosophy of clarifying concepts such as those of thinking, knowing and believing. The task of clarifying these concepts has become ever more important with the major developments that have (...) taken place over the last century in the human and cognitive sciences - most notably, psychology, sociology, linguistics, neurophysiology, AI, and cognitive science itself. In all these sciences, there is a need to delineate the domain of the mental and to elucidate the key concepts and underlying assumptions. This need is widely recognized, but approaches and answers vary significantly. Some stress the representational features involved in most of our mental processes, others the inferential dimension; some stress the necessity of using empirical data, others the need to refine ideas before pursuing and drawing on empirical research. The papers collected in this volume are grouped into four parts, on language and thought, on knowledge, belief and action, on intentionality, and on naturalism. The volume will be welcomed by all those engaged and interested in debates about the mental in philosophy and the human and cognitive sciences. (shrink)

This article draws on the insight that people and communities have fundamental relationships with place. People are defined and shaped by place; and place is, in turn, defined and shaped by communi...

Mass incarceration and the aging prison population in the United States is an ethical crisis, understudied in empirical bioethics research. In this article, I share one woman’s narrative to illustrate how older Black women describe accessing healthcare while incarcerated and identify sites for bioethical exploration. I argue that, due to the punitive nature of prison healthcare interactions, wherein women are seen as inmates first and patients second, healthcare providers are caught in a trap of competing ethical commitments to their patients (...) and the state. As the prison population ages, these challenges will become more acute. Feminist bioethics has a critical role to play in imagining new possibilities for accessing, giving, and receiving care in the carceral context. (shrink)

In this article, we investigate the role of scientific and patient narratives on perceptions of the medical debate around gestational diabetes testing. Among medical scientists, we show that the narrative surrounding GDM testing affirms that future research and data will lead to medical consensus. We call this narrative trajectory the “deferred quest.” For patients, however, diagnosis and their subsequent discovery that biomedicine does not speak in one voice ruptures their trust in medical authority. This new distrust creates space for patients (...) to develop a Frankian quest narrative where they become the protagonist in their story. Additionally, across these different narratives, we observe how character is constructed and employed to negotiate trust. We conclude that healthcare providers should assess the narrative trajectory adopted by patients after diagnosis. Also, we suggest that providers acknowledge the lack of medical consensus to their patients. This veracity would foster women’s sense of trust in their provider as well as allow women to be active interlocutors in a debate that ultimately plays out in their deliberation about their body, pregnancy, and risk. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.1 (2003) 57-62 [Access article in PDF] Listening to People Or Listening to Prozac?Another Consideration of Causal Classifications Jennifer Hansen Keywords causal classification, descriptivism, melancholia, neurasthenia, depression, cultural relativism. The shape and detail of depression have gone through a thousand cartwheels, and the treatment of depression has alternated between the ridiculous and the sublime, but the excessive sleeping, inadequate eating, suicidiality, withdrawal from social (...) interaction, and relentless despair are all as old as the hill tribes, if not as old as the hills. In the years since man achieved the capacity for self-reference, shame has come and gone; treatments for bodily complaints have alternated and crossed with treatments for spiritual ones; pleas to external gods have echoed pleas to internal demons. To understand the history of depression is to understand the invention of human being as we now know and are him. Our Prozac-popping, cognitively focused, semi-alienated postmodernity is only a stage in the ongoing understanding and control of mood and character. (Solomon 2001, 286) ALTHOUGH ANDREW SOLOMON clearly believes that "the shape and detail of depression have gone through a thousand cartwheels," Jennifer Radden gives us pause before assuming that depression is just another name for Dame Melancholy. Solomon's claim depends on a deeper metaphysical claim about the nature of depression and its causes. The current method of psychiatric nosology, descriptivism, does not necessarily support equating melancholia and depression. Furthermore, it appears that adopting descriptivism as the sole method of classifying mental disorders commits us to cultural relativist psychiatry. Below I reconsider whether we want to rule out causal classifications and suggest that embracing both descriptivism and causal classifications offer us greater possibilities in understanding human illness and culture.Although the occasion for Jennifer Radden's essay is to investigate whether or not melancholia and depression refer to the same thing, her essay detours into a consideration of extra-descriptivist models of psychiatric illness versus the descriptivism of current psychiatric nosology. This detour turns out to be warranted; her purely academic question yields to a timelier question concerning the proper methodology for classifying mental disorders. Whereas debates about psychiatric nosology are perennial, the recent success of the new generation of antidepressants [End Page 57] is reviving biological psychiatry and its search for the neurochemical origins of depression. Hence, embedded in Radden's question concerning whether or not melancholia is the same thing as clinical depression, is another important question concerning the causes of mental illness, particularly depression.Currently, with its descriptivist approach, the Diagnostic and Statistical Manual of Mental Disorders (DSM) does not classify mental illness, such as clinical depression, based on underlying causes. The cluster of symptoms and behavioral signs that lead a clinician to diagnose one as depressed that are contained in either the DSM or the International Classification of Diseases (ICD) may be too fuzzy or elusive to give any clear distinction between major depression, mild depression, and the blues. For example, one group of epidemiologists points out that [t]he DSM-III, DSM-III-R, and DSM-IV acknowledge that depression, like many mental disorders, has no currently obvious natural classes... If natural classes of depression exist, then their nosology awaits the discovery of distinct and reliable genetic, biological, clinical, or other predictors of risk, severity, or clinical course. Clinicians have a tradition of separating depressions into subtypes; however, this subtyping has not yet led to clear-cut delineations of syndromes in populations. (Kaelber 1995, 4) The evidence is still insufficient to establish the biological or psychological origins of depression. Although many theories exist that explain why people become depressed, scientifically we are not yet in a position to determine which is the right theory. From a pragmatic perspective, however, whether or not we know what causes depression, we can nonetheless attempt to alleviate suffering from depression. And it is with this goal in mind that the DSM-IV and ICD-10 classify mental disorders.Now, given that our current methodology for psychiatric nosology does not establish causes, it is also insufficient for determining what... (shrink)

Book synopsis: Criminal law has been described as a species of political and moral philosophy; whether that can be said to be true is not at all certain, but criminal law can be the subject of philosophical study. The aim of this book is to explore some of the philosophical foundations of the criminal law. The distinguished English and North American contributors to this volume have all produced original and sparkling essays which will command attention.

As an environmentally focused, applied field science, fisheries biology has recently been marked by its failed promise to enable sustainable exploitation. Fisheries biology’s origin through state support raises many questions. How did fisheries biologists get this support? Did political considerations and economic ideals fundamentally shape the science? Why has it been perceived as fundamentally conservation oriented? New evidence indicates the political basis for Thomas Henry Huxley’s contention that the deep-sea fisheries were inexhaustible; this essay shows how his influence extended to (...) recent neoliberal resource management solutions. It also explores how fisheries biology acquired the ideal of maximum sustained yield via Progressive Era efficiency conservation and German scientific forestry; how American Cold War foreign policy made this ideal paradigmatic of mid to late twentieth-century fisheries biology; and how emerging bioeconomics in the 1950s imposed a troublesome misunderstanding of fisheries biology’s earlier mission. (shrink)

We establish that for every computably enumerable (c.e.) Turing degree b the upper cone of c.e. Turing degrees determined by b is the degree spectrum of the successor relation of some computable linear ordering. This follows from our main result, that for a large class of linear orderings the degree spectrum of the successor relation is closed upward in the c.e. Turing degrees.

While contractualism seems to solve some of the more pressing concerns of other moral theories, it does not conclusively address the moral status of non-human animals. Peter Carruthers claims that contractualism excludes animals from having full moral status. I argue that Carruthers’ arguments are fatally flawed due to his reliance on contradictory claims, unlikely assumptions, and flagrant violations of the contractualist method. However, Carruthers also claims that we can treat animals wrongly and that it deserves moral criticism. This claim is (...) based in indirect moral significance. However, this position makes it impossible for Carruthers to avoid endorsing two extremely counter-intuitive claims. The work of C. Tucker and C. MacDonald allows us to demonstrate that contractualism does give animals full moral standing. They ground the criteria for a contracting agent in three characteristics that animals possess. A look at some possible objections reveals nothing devastating to their proposal. (shrink)

When faced with an ambiguous pronoun, comprehenders use both multimodal cues and linguistic cues to identify the antecedent. While research has shown that gestures facilitate language comprehension, improve reference tracking, and influence the interpretation of ambiguous pronouns, literature on reference resolution suggests that a wide set of linguistic constraints influences the successful resolution of ambiguous pronouns and that linguistic cues are more powerful than some multimodal cues. To address the outstanding question of the importance of gesture as a cue in (...) reference resolution relative to cues in the speech signal, we have previously investigated the comprehension of contrastive gestures that indexed abstract referents – in this case expressions of personal preference – and found that such gestures did facilitate the resolution of ambiguous statements of preference. In this study, we extend this work to investigate whether the effect of gesture on resolution is diminished when the gesture indexes a statement that is less likely to be interpreted as the correct referent. Participants watched videos in which a speaker contrasted two ideas that were either neutral or moral acceptable). A gesture to the left or right side co-occurred with speech expressing each position. In gesture-disambiguating trials, an ambiguous phrase was accompanied by a gesture to one side or the other. In gesture non-disambiguating trials, no third gesture occurred with the ambiguous phrase. Participants were more likely to choose the idea accompanied by gesture as the stimulus speaker’s preference. We found no effect of scenario type. Regardless of whether the linguistic cue expressed a view that was morally charged or neutral, observers used gesture to understand the speaker’s opinion. This finding contributes to our understanding of the strength and range of cues, both linguistic and multimodal, that listeners use to resolve ambiguous references. (shrink)

The promotion of rights, autonomy and choice reacts against paternalism, an early twentieth-century response to intellectual disability that suppressed individual personhood through a combination of resource limitations and poor administration. These liberal individualist concepts reflect the contemporary zeitgeist of Anglophone nations, although the strength and certainty with which these concepts are expressed in ID policy when compared with policy for other vulnerable groups suggests that they also serve a secondary function. It has been argued that excessive certainty in ID evidences (...) a feared drop... (shrink)

The evidence is clear and consistent that African Americans and Hispanics are treated differently depending on their skin color within their racial or ethnic group, and yet the surveys that show these results also show very few political or political-psychological patterns as a result of skin color. To investigate why this is so, this paper uses the fact that discriminatory treatment by skin color does not necessarily result in political action or perceptions around that discrimination to raise the larger question (...) of when racial or ethnic groups see and protest unfairness, and when they do not. My hypotheses about why this occurs differ for blacks and Latinos. In the former case, the ideology of group consciousness is strong enough, and embarrassment about internal skin-color hierarchy is powerful enough, that blacks don't want to recognize differences by skin color. Light-skinned blacks, in fact, may be more racially identified than dark-skinned blacks — so their economic and social advantages are offset by their commitments to their race as a whole, and they behave politically like dark-skinned blacks do. The case of Hispanics may be better explained in terms of a weak sense of group consciousness rather than a strong one. That is, Latinos may not think of themselves as a group, such that they see skin color differentiation as a consequence of being members of different races rather than as a form of discrimination against some members of "their" group. (shrink)

The “prescription” of humans' social learning bifocals is fine-tuned by cultural norms and, as a result, the readiness with which the instrumental or conventional lenses are used to view behavior differs across cultures. We present evidence for this possibility from cross-cultural work examining children's imitation and innovation.

This paper analyses the forgotten concept of “sperm-force” proposed by George Newport (1803–1854). Newport is known for his comprehensive microscopic examinations of sperm and egg interaction in amphibian fertilization between 1850 and 1854. My work with archival sources reveals that Newport believed fertilization was caused by sperm-force, which the Royal Society refused to publish. My reconstruction chronologically traces the philosophical and experimental origins of sperm-force to Newport’s 1830s entomological work. Sperm-force is a remnant of Newport’s speculations on the creation of (...) the active individual. I argue that sperm-force was rooted in British interpretations of German _Naturphilosophie_, which demonstrates Continental influences on mid-Victorian embryology, particularly the role of male generative power. This context provides further evidence that British versions of Romantic science fostered sophisticated experimental work. The refusal by Paleyite stalwarts of natural theology to publish Newport’s ideas illustrates the institutional resistance to German pantheistic and vitalistic influences. This reconstruction of sperm-force’s philosophical foundation and its reception offers new understandings of mid-Victorian attitudes toward the inheritance of mind and body. It situates Newport’s work within the nineteenth century’s scientific project to assign stereotypical genders to the gametes. (shrink)

This article argues that a state-centered theory of global justice exhibits an epistemic problem of perspective, and that this worry exhibits a gendered character. Within a liberal domestic theory of justice, the public/private distinction has been repeatedly shown to be bad for women because it creates a domain for injustice that becomes invisible to public policy and the law. This article argues that state-centered theories of global justice create an analogous space that is cut off from questions of global justice. (...) The article therefore suggests that this way of framing questions of global justice is problematic, and is problematic for women in particular. Just as the public/private distinction in liberal domestic justice leaves cases of injustice outside the vision of the law, the hard distinction between the domestic (state) sphere and the international realm of justice leaves cases of injustice invisible to international law. For the question of global justice, the privileging of sovereignty and non-intervention compromises the ability of the theory to achieve its purported goal of universal justice. (shrink)