When making substituted judgments for incapacitated patients, surrogates often struggle to guess what the patient would want if they had capacity. Surrogates may also agonize over having the (sole) responsibility of making such a determination. To address such concerns, a Patient Preference Predictor (PPP) has been proposed that would use an algorithm to infer the treatment preferences of individual patients from population-level data about the known preferences of people with similar demographic characteristics. However, critics have suggested that even if such (...) a PPP were more accurate, on average, than human surrogates in identifying patient preferences, the proposed algorithm would nevertheless fail to respect the patient’s (former) autonomy since it draws on the ‘wrong’ kind of data: namely, data that are not specific to the individual patient and which therefore may not reflect their actual values, or their reasons for having the preferences they do. Taking such criticisms on board, we here propose a new approach: the Personalized Patient Preference Predictor (P4). The P4 is based on recent advances in machine learning, which allow technologies including large language models to be more cheaply and efficiently ‘fine-tuned’ on person-specific data. The P4, unlike the PPP, would be able to infer an individual patient’s preferences from material (e.g., prior treatment decisions) that is in fact specific to them. Thus, we argue, in addition to being potentially more accurate at the individual level than the previously proposed PPP, the predictions of a P4 would also more directly reflect each patient’s own reasons and values. In this article, we review recent discoveries in artificial intelligence research that suggest a P4 is technically feasible, and argue that, if it is developed and appropriately deployed, it should assuage some of the main autonomy-based concerns of critics of the original PPP. We then consider various objections to our proposal and offer some tentative replies. (shrink)

We can freely cross disciplinary boundaries, as well as the line between theory and practice, and allow practices to cast their light back on the theory and show us its deficiencies. In short, this approach reorients some much-discussed issues of professional, business, and military ethics and reveals them as variations on one deeply rooted theme. The author does not treat current institutions as final and unalterable. If these arrangements frustrate moral evaluation, she finds that an argument for change. To make (...) intelligent changes, however, we need a clear view of the reasoning that makes them seem natural and inevitable. That is what this book attempts to do. In the process, the author also reexamines the concept of "person." Not all cultures put so much stress on the idea as Western - and particularly American - cultures do. If we wish to keep this emphasis, then here is another argument for change. (shrink)

Purpose This paper aims to formalize long-term trajectories of human civilization as a scientific and ethical field of study. The long-term trajectory of human civilization can be defined as the path that human civilization takes during the entire future time period in which human civilization could continue to exist. -/- Design/methodology/approach This paper focuses on four types of trajectories: status quo trajectories, in which human civilization persists in a state broadly similar to its current state into the distant future; catastrophe (...) trajectories, in which one or more events cause significant harm to human civilization; technological transformation trajectories, in which radical technological breakthroughs put human civilization on a fundamentally different course; and astronomical trajectories, in which human civilization expands beyond its home planet and into the accessible portions of the cosmos. -/- Findings Status quo trajectories appear unlikely to persist into the distant future, especially in light of long-term astronomical processes. Several catastrophe, technological transformation and astronomical trajectories appear possible. -/- Originality/value Some current actions may be able to affect the long-term trajectory. Whether these actions should be pursued depends on a mix of empirical and ethical factors. For some ethical frameworks, these actions may be especially important to pursue. (shrink)

Several studies show that healthcare professionals need to communicate inter-professionally in order to manage ethical difficulties. A model of clinical ethics support inspired by Habermas’ theory of discourse ethics has been developed by our research group. In this version of CES sessions healthcare professionals meet inter-professionally to communicate and reflect on ethical difficulties in a cooperative manner with the aim of reaching communicative agreement or reflective consensus. In order to understand the course of action during CES, the aim of this (...) study was to describe the communication of value conflicts during a series of inter-professional CES sessions. Ten audio- and video-recorded CES sessions were conducted over eight months and were analyzed by using the video analysis tool Transana and qualitative content analysis. The results showed that during the CES sessions the professionals as a group moved through the following five phases: a value conflict expressed as feelings of frustration, sharing disempowerment and helplessness, the revelation of the value conflict, enhancing realistic expectations, seeing opportunities to change the situation instead of obstacles. In the course of CES, the professionals moved from an individual interpretation of the situation to a common, new understanding and then to a change in approach. An open and permissive communication climate meant that the professionals dared to expose themselves, share their feelings, face their own emotions, and eventually arrive at a mutual shared reality. The value conflict was not only revealed but also resolved. (shrink)

The next World Congress of Bioethics will be held in Doha, Qatar. Although this location provides opportunities to interact with a more culturally diverse audience, to advance dialogue between cultures and religions, offer opportunities for mutual learning, there are also huge moral concerns. Qatar is known for violations of human rights ‐ including the treatment of migrant workers and the rights of women ‐ corruption, criminalization of LGBTQI+ persons, and climate impact. Since these concerns are also key (bio)ethical concern we (...) call for a broad debate within the bioethics community whether organizing and attending the World Congress in Qatar is ethically problematic and how ethical concerns should be dealt with. (shrink)

Driven by interests in workforce planning and patient safety, a growing body of literature has begun to identify the reality and the prevalence of missed nursing care, also specified as care left undone, rationed care or unfinished care. Empirical studies and conceptual considerations have focused on structural issues such as staffing, as well as on outcome issues – missed care/unfinished care. Philosophical and ethical aspects of unfinished care are largely unexplored. Thus, while internationally studies highlight instances of covert rationing/missed care/care (...) left undone – suggesting that nurses, in certain contexts, are actively engaged in rationing care – in terms of the nursing and nursing ethics literature, there appears to be a dearth of explicit decision-making frameworks within which to consider rationing of nursing care. In reality, the assumption of policy makers and health service managers is that nurses will continue to provide full care – despite reducing staffing levels and increased patient turnover, dependency and complexity of care. Often, it would appear that rationing/missed care/nursing care left undone is a direct response to overwhelming demands on the nursing resource in specific contexts. A discussion of resource allocation and rationing in nursing therefore seems timely. The aim of this discussion paper is to consider the ethical dimension of issues of resource allocation and rationing as they relate to nursing care and the distribution of the nursing resource. (shrink)

The under-representation of women on boards is a heavily discussed topic—not only in Germany. Based on critical mass theory and with the help of a hand-collected panel dataset of 151 listed German firms for the years 2000–2005, we explore whether the link between gender diversity and firm performance follows a U-shape. Controlling for reversed causality, we find evidence for gender diversity to at first negatively affect firm performance and—only after a “critical mass” of about 30 % women has been reached—to (...) be associated with higher firm performance than completely male boards. Given our sample firms, the critical mass of 30 % women translates into an absolute number of about three women on the board and hence supports recent studies on a corresponding “magic number” of women in the boardroom. (shrink)

Population-level biomedical research offers new opportunities to improve population health, but also raises new challenges to traditional systems of research governance and ethical oversight. Partly in response to these challenges, various models of public involvement in research are being introduced. Yet, the ways in which public involvement should meet governance challenges are not well understood. We conducted a qualitative study with 36 experts and stakeholders using the World Café method to identify key governance challenges and explore how public involvement can (...) meet these challenges. This brief report discusses four cross-cutting themes from the study: the need to move beyond individual consent; issues in benefit and data sharing; the challenge of delineating and understanding publics; and the goal of clarifying justifications for public involvement. The report aims to provide a starting point for making sense of the relationship between public involvement and the governance of population-level biomedical research, showing connections, potential solutions and issues arising at their intersection. We suggest that, in population-level biomedical research, there is a pressing need for a shift away from conventional governance frameworks focused on the individual and towards a focus on collectives, as well as to foreground ethical issues around social justice and develop ways to address cultural diversity, value pluralism and competing stakeholder interests. There are many unresolved questions around how this shift could be realised, but these unresolved questions should form the basis for developing justificatory accounts and frameworks for suitable collective models of public involvement in population-level biomedical research governance. (shrink)

We apply Benacerraf’s distinction between mathematical ontology and mathematical practice to examine contrasting interpretations of infinitesimal mathematics of the seventeenth and eighteenth century, in the work of Bos, Ferraro, Laugwitz, and others. We detect Weierstrass’s ghost behind some of the received historiography on Euler’s infinitesimal mathematics, as when Ferraro proposes to understand Euler in terms of a Weierstrassian notion of limit and Fraser declares classical analysis to be a “primary point of reference for understanding the eighteenth-century theories.” Meanwhile, scholars like (...) Bos and Laugwitz seek to explore Eulerian methodology, practice, and procedures in a way more faithful to Euler’s own. Euler’s use of infinite integers and the associated infinite products are analyzed in the context of his infinite product decomposition for the sine function. Euler’s principle of cancellation is compared to the Leibnizian transcendental law of homogeneity. The Leibnizian law of continuity similarly finds echoes in Euler. We argue that Ferraro’s assumption that Euler worked with a classical notion of quantity is symptomatic of a post-Weierstrassian placement of Euler in the Archimedean track for the development of analysis, as well as a blurring of the distinction between the dual tracks noted by Bos. Interpreting Euler in an Archimedean conceptual framework obscures important aspects of Euler’s work. Such a framework is profitably replaced by a syntactically more versatile modern infinitesimal framework that provides better proxies for his inferential moves. (shrink)

Of all moral conditions, innocence seems easily the best and most desirable, for it means the complete absence of error and regret and all the anxieties that go with these—anxieties about avoiding guilt and making amends for instance. Against the background of guilt and traffic with wrong, innocence is indisputably better, just as something clean is better than something soiled, something fresh better than something stale.

An atomistic model of society leads us to address injustices in terms of individual rights, but rights are curious possessions and don't always give the protection that's needed. Examples are patient's rights, children's rights and a fetus's right to life, all of which go wrong because they assume that the subjects are independent and autonomous. This assumption often fails. Rights work where people are in a position to press them; for others they give only a caricature of justice.

In this article, a teleological model for analysis of everyday ethical situations in dementia care is used to analyse and clarify perennial ethical problems in nursing home care for persons with dementia. This is done with the aim of describing how such a model could be useful in a concrete care context. The model was developed by Sandman and is based on four aspects: the goal; ethical side-constraints to what can be done to realize such a goal; structural constraints; and (...) nurses’ ethical competency. The model contains the following main steps: identifying and describing the normative situation; identifying and describing the different possible alternatives; assessing and evaluating the different alternatives; and deciding on, implementing and evaluating the chosen alternative. Three ethically difficult situations from dementia care were used for the application of the model. The model proved useful for the analysis of nurses’ everyday ethical dilemmas and will be further explored to evaluate how well it can serve as a tool to identify and handle problems that arise in nursing care. (shrink)

Recently Robert B. Talisse has put forth a socio-epistemic justification of liberal democracy that he believes qualifies as a public justification in that it purportedly can be endorsed by all reasonable individuals. In avoiding narrow restraints on reasonableness, Talisse argues that he has in fact proposed a justification that crosses the boundaries of a wide range of religious, philosophical and moral worldviews and in this way the justification is sufficiently pluralistic to overcome the challenges of reasonable pluralism familiar from Rawls. (...) The fascinating argument that Talisse furthers is that when cognitively functional individuals reflect on some of their most basic epistemic commitments they will come to see that, in virtue of these commitments, they are also committed to endorsing key liberal democratic institutions. We argue that the socio-epistemic justification can be reasonably rejected on its own terms and thus fails as a public justification approach. This point is made by illustrating the significance of deep epistemic disagreements in liberal democracies. (shrink)

Models of dream analysis either assume a continuum of waking and dreaming or the existence of two dissociated realities. Both approaches rely on different methodology. Whereas continuity models are based on content analysis, discontinuity models use a structural approach. In our study, we applied both methods to test specific hypotheses about continuity or discontinuity. We contrasted dream reports of congenitally deaf-mute and congenitally paraplegic individuals with those of non-handicapped controls. Continuity theory would predict that either the deficit itself or compensatory (...) experiences would surface in the dream narrative. We found that dream form and content of sensorially limited persons was indifferent from those of non-handicapped controls. Surprisingly, perceptual representations, even of modalities not experienced during waking, were quite common in the dream reports of our handicapped subjects. Results are discussed with respect to feedforward mechanisms and protoconsciousness theory of dreaming. (shrink)

This rich and diverse collection offers a range of perspectives and practices of Philosophy for Children (P4C). P4C has become a significant educational and philosophical movement with growing impact on schools and educational policy. Its community of inquiry pedagogy has been taken up in community, adult, higher, further and informal educational settings around the world. The internationally sourced chapters offer research findings as well as insights into debates provoked by bringing children’s voices into moral and political arenas and to philosophy (...) and the broader educational issues this raises, for example: historical perspectives on the field; democratic participation and epistemic, pedagogical and political relationships; philosophy as a subject and philosophy as a practice; philosophical teaching across the curriculum; embodied enquiry, emotions and space; knowledge, truth and philosophical progress; resources and texts for philosophical inquiry; ethos and values of P4C practice and research. The Routledge International Handbook of Philosophy for Children will spark new discussions and identify emerging questions and themes in this diverse and controversial field. It is an accessible, engaging and provocative read for all students, researchers, academics and educators who have an interest in Philosophy for Children, its educational philosophy and its pedagogy. (shrink)

Discusses the theory of social atomism, individual rights, majority rule, government representation, justice, punishment, and freedom.

Abraham Robinson’s framework for modern infinitesimals was developed half a century ago. It enables a re-evaluation of the procedures of the pioneers of mathematical analysis. Their procedures have been often viewed through the lens of the success of the Weierstrassian foundations. We propose a view without passing through the lens, by means of proxies for such procedures in the modern theory of infinitesimals. The real accomplishments of calculus and analysis had been based primarily on the elaboration of novel techniques for (...) solving problems rather than a quest for ultimate foundations. It may be hopeless to interpret historical foundations in terms of a punctiform continuum, but arguably it is possible to interpret historical techniques and procedures in terms of modern ones. Our proposed formalisations do not mean that Fermat, Gregory, Leibniz, Euler, and Cauchy were pre-Robinsonians, but rather indicate that Robinson’s framework is more helpful in understanding their procedures than a Weierstrassian framework. (shrink)

In relation to a thesis put forward by Marx Wartofsky, we seek to show that a historiography of mathematics requires an analysis of the ontology of the part of mathematics under scrutiny. Following Ian Hacking, we point out that in the history of mathematics the amount of contingency is larger than is usually thought. As a case study, we analyze the historians’ approach to interpreting James Gregory’s expression ultimate terms in his paper attempting to prove the irrationality of \. Here (...) Gregory referred to the last or ultimate terms of a series. More broadly, we analyze the following questions: which modern framework is more appropriate for interpreting the procedures at work in texts from the early history of infinitesimal analysis? As well as the related question: what is a logical theory that is close to something early modern mathematicians could have used when studying infinite series and quadrature problems? We argue that what has been routinely viewed from the viewpoint of classical analysis as an example of an “unrigorous” practice, in fact finds close procedural proxies in modern infinitesimal theories. We analyze a mix of social and religious reasons that had led to the suppression of both the religious order of Gregory’s teacher degli Angeli, and Gregory’s books at Venice, in the late 1660s. (shrink)

Liao and Carbonell discuss the role of (supposed) racial differences and racism in two medical devices: pulse oximeters and spirometers. They show that what might seem like cases of mere bias, are...

Exposome research is put forward as a major tool for solving the nature-versus-nurture debate because the exposome is said to represent “the nature of nurture.” Against this influential idea, we argue that the adoption of the nature-versus-nurture debate into the exposome research program is a mistake that needs to be undone to allow for a proper bioethical assessment of exposome research. We first argue that this adoption is originally based on an equivocation between the traditional nature-versus-nurture debate and a debate (...) about disease prediction/etiology. Second, due to this mistake, exposome research is pushed to adopt a limited conception of agential control that is harmful to one's thinking about the good that exposome research can do for human health and wellbeing. To fully excise the nature-versus-nurture debate from exposome research, we argue that exposome researchers and bioethicists need to think about the exposome afresh from the perspective of actionability. We define the concept of actionability and related concepts and show how these can be used to analyze the ethical aspects of the exposome. In particular, we focus on refuting the popular “gun analogy” in exposome research, returning results to study participants and risk-taking in the context of a well-lived life. (shrink)

A common justification for retributive views of punishment is the idea that injustice is intolerable and must be answered. For instance F. H. Bradley writes:Why … do I merit punishment? It is because I have been guilty. I have done ‘wrong’… Now the plain man may not know what he means by ‘wrong’, but he is sure that, whatever it is, it ‘ought’ not to exist, that it calls and cries for obliteration; that, if he can remove it, it rests (...) also upon him, and that the destruction of guilt, whatever be the consequences, and even if there be no consequences at all, is still a good in itself; and this, not because a mere negation is a good, but because the denial of wrong is the assertion of right.A wrong is something that ought not to exist and calls to be obliterated. If anyone is able to remove it, he is obligated to do so or the wrong will also be partly his. To deny or obliterate a wrong is to assert right, Bradley says—as if the two things were counterpoised, one able to cancel the other. It reminds us of the balance held by the figure of Justice, and of debts and credits in accounts. Paying a debt erases it; the debt no longer exists. In a similar way punishment is supposed to erase wrong. (shrink)

In moral as in other branches of philosophy good examples are indispensable: examples, that is, which bring out the real force of the ways in which we speak and in which language is not ‘ on holiday’. Peter Winch, ‘The Universalizability of Moral Judgments.’.

Wittgenstein remarked to a friend that although he was not religious, he approached things from "a religious point of view." To cast light on what he meant I turn to two works Wittgenstein is known to have read and admired, one by William James and the other by Leo Tolstoy. I looked for similar themes in their work and the philosophical works of Wittgenstein, with results that, while not conclusive, are quite suggestive.

One of Darwin’s purposes in writing The Origin of Species was to rebut the doctrine of separate creations. Moreover, the argument he was chiefly concerned with—which was both his target and the model of his own argument—was the familiar argument from design.

Different types of tasks exist, including tasks for research purposes or exams assessing knowledge. According to expectation-value theory, tests are related to different levels of effort and importance within a test taker. Test-taking effort and importance in students decreased over the course of high-stakes tests or low-stakes-tests in research on test-taking motivation. However, whether test-order changes affect effort, importance, and response processes of education students have seldomly been experimentally examined. We aimed to examine changes in effort and importance resulting from (...) variations in test battery order and their relations to response processes. We employed an experimental design assessing N = 320 education students’ test-taking effort and importance three times as well as their performance on cognitive ability tasks and a mock exam. Further relevant covariates were assessed once such as expectancies, test anxiety, and concentration. We randomly varied the order of the cognitive ability test and mock exam. The assumption of intraindividual changes in education students’ effort and importance over the course of test taking was tested by one latent growth curve that separated data for each condition. In contrast to previous studies, responses and test response times were included in diffusion models for examining education students’ response processes within the test-taking context. The results indicated intraindividual changes in education students’ effort or importance depending on test order but similar mock-exam response processes. In particular effort did not decrease, when the cognitive ability test came first and the mock exam subsequently but significantly decreased, when the mock exam came first and the cognitive ability test subsequently. Diffusion modeling suggested differences in response processes on cognitive ability tasks suggesting higher motivational levels when the cognitive ability test came first than vice versa. The response processes on the mock exam tasks did not relate to condition. (shrink)

An essay to develop some of Wittgenstein's remarks about the notion of 'criteria' and to give the concept clarity even at the expense of some features Wittgenstein claimed for it. This effort was made because of the important role 'criteria' plays in Wittgenstein's discussions of feelings and mental states, and it is hoped that a defense of 'criteria' will make those discussions more coherent. An attempt is made to relate this notion of 'criteria' to the definition and expression of mental (...) states, following some of Wittgenstein's suggestions, and to rebut skepticism about other minds. (shrink)

The present study assessed business students’ responses to an innovative interactive presentation on academic integrity that employed quoted material from previous students as launching points for discussion. In total, 15 business classes ( n = 412 students) including 2nd, 3rd and 4th year level students participated in the presentations as part of the ethics component of ongoing courses. Students’ perceptions of the importance of academic integrity, self-reports of cheating behaviors, and factors contributing to misconduct were examined along with perceptions about (...) the presentation. Discussion sessions revealed that academic misconduct is a complex issue. For example, knowledge of what constitutes misconduct was not consistent across domains (e.g. exam contexts versus group work), penalties were not wholly known, and there was variation in perceived responsibility for reporting and representing academic integrity. Survey measures revealed that self-reported academic misconduct was more prevalent than expected with only 7.5% of students indicating they had never cheated in any way. Furthermore, results showed gender and year of study as predictive factors for issues related to academic misconduct. In general, students were receptive to this form of presentation. The implications of such instructional interventions for enhancing ethical behaviors in higher education classrooms are discussed. (shrink)