This article examines the role of medical doctors, AI designers, and other stakeholders in making applied AI and machine learning ethically acceptable on the general premises of shared decision-making in medicine. Recent policy documents such as the EU strategy on trustworthy AI and the research literature have often suggested that AI could be made ethically acceptable by increased collaboration between developers and other stakeholders. The article articulates and examines four central alternative models of how AI can be designed and applied (...) in patient care, which we call the ordinary evidence model, the ethical design model, the collaborative model, and the public deliberation model. We argue that the collaborative model is the most promising for covering most AI technology, while the public deliberation model is called for when the technology is recognized as fundamentally transforming the conditions for ethical shared decision-making. (shrink)

Large-scale sequencing tests, including whole-exome and whole-genome sequencing, are rapidly moving into clinical use. Sequencing is already being used clinically to identify therapeutic opportunities for cancer patients who have run out of conventional treatment options, to help diagnose children with puzzling neurodevelopmental conditions, and to clarify appropriate drug choices and dosing in individuals. To evaluate and support clinical applications of these technologies, the National Human Genome Research Institute and National Cancer Institute have funded studies on clinical and research sequencing under (...) the Clinical Sequencing Exploratory Research program as well as studies on return of results. Most of these studies use sequencing in real-world clinical settings and collect data on both the application of sequencing and the impact of receiving genomic findings on study participants. They are occurring in the context of controversy over how to obtain consent for exome and genome sequencing. (shrink)

Medicine is not merely a job that requires technical expertise, but a profession concerned with making the best decisions and recommendations with reference to, and in consultation with, the patient. This means that the skill set required for healthcare professionals in order to provide good care is a combination of scientific knowledge, technical aptitude, and affective qualities or virtues such as compassion and empathy.

Current debate and policy surrounding the use of genetic editing in humans often relies on a binary distinction between therapy and human enhancement. In this paper, we argue that this dichotomy fails to take into account perhaps the most significant potential uses of CRISPR-Cas9 gene editing in humans. We argue that genetic treatment of sporadic Alzheimer’s disease, breast- and ovarian-cancer causing BRCA1/2 mutations and the introduction of HIV resistance in humans should be considered within a new category of genetic protection (...) treatments. We find that if this category is not introduced, life-altering research might be unnecessarily limited by current or future policy. Otherwise ad hoc decisions might be made, which introduce a risk of unforeseen moral costs, and might overlook or fail to address some important opportunities. (shrink)

Education and cognition research today generally recognize the tri-dimensional nature of reasoning processes as involving cognitive, social and emotional phenomena. However, there is so far no theoretical framework articulating these three dimensions from a descriptive perspective. This paper aims at presenting a first model of how group emotions work in collective reasoning, and specifies their social and cognitive functions. This model is inspired both from a multidisciplinary literature review and our extensive previous empirical work on an international corpus of videotaped (...) student debates. The cognitive function of emotions is defined in reference to the process of schematization and associated emotional framing. On the other hand, the social function of emotions refers to recognition-oriented behaviors that correspond to engagement into specific types of group talk, implying specific politeness rules or face-preservation systems. We believe that our multi-dimensional and multi-level approach to group reasoning, which mostly employs a linguistic perspective, can be applied to a diversity of contexts. We hope it will serve as a basis for further discussion on the role of emotions in reasoning among the interdisciplinary community of argumentation studies. (shrink)

The concept of legitimacy is often used and emphasized in the context of setting limits in health care, but rarely described is what is actually meant by its use. Moreover, it is seldom explicitly stated how health-care workers can contribute to the matter, nor what weight should be apportioned to their viewpoints. Instead the discussion has focused on whether they should take on the role of the patients’ advocate or that of gatekeeper to the society’s resources. In this article, we (...) shed light on the role of health-care workers in limit setting and how their conferred legitimacy may support subordinators’ (i.e. citizens’) conferred legitimacy. We argue that health-care workers have an important role to play as both moral and political agents in limit setting, and delineate normative conditions that justify and facilitate health-care workers in conferring legitimacy on this kind of decision. Their role and potential impact on political limit setting does not—theoretically—affect the idea of democratic legitimacy negatively. Rather, as we suggest, by designing for limit-setting policymaking accordingly, health-care workers, as well as citizens, are more justified in conferring democratic legitimacy to health-care limit-setting decisions than if these concerns were not addressed. (shrink)

Ellen Gleditsch (1879–1968) became Norway’s first authority on radioactivity and the country’s second female full professor. From her many years abroad—in Marie Curie’s laboratory in Paris and at Yale University in New Haven with Bertram Boltram—she became internationally acknowledged and developed an extensive personal and scientific network. In the Norwegian scientific community she was, however, less appreciated, and her appointment as a professor in 1929 caused controversy. Despite the recommendation of the expert committee, her predecessor and his allies spread the (...) view that Gleditsch was a diligent but outdated researcher with little scientific promise—a view that apparently persists in the Norwegian chemical community today. In addition to her scientific work, Gleditsch acquired political influence by joining the International Federation of University Women in 1920; she later became the president of both the Norwegian section and the worldwide organization. She worked in particular to establish scholarships enabling women to go abroad. I once worked with a learned man who was reputed to hate women. On one occasion he stated that the new collaborator was a rare exception. When he was asked why he said, “She does not scream.” I heard this several months later and have kept it as a great compliment; yes—the biggest in my scientific career. —Ellen Gleditsch. (shrink)

Background: When a genetic mutation is identified in a family member, internationally, it is usually the proband’s or another responsible family member’s role to disclose the information to at-risk relatives. However, both active and passive non-disclosure in families occurs: choosing not to communicate the information or failing to communicate the information despite intention to do so, respectively. The ethical obligations to prevent harm to at-risk relatives and promote the duty of care by genetic health professionals is in conflict with Privacy (...) laws and professional regulations that prohibits disclosure of information to a third party without the consent of the proband. In New South Wales, Australia, amendments to Privacy legislation permits such disclosure to living genetic relatives with the process defined under guidelines although there is no legal duty to warn. This study assessed NSW GHP’s awareness and experience of the legislation and guidelines. Methods: An online survey collected demographics; theoretical knowledge; clinical scenarios to assess application knowledge; attitudes; confidence; experience with active non-disclosure. A link to correct answers was provided after completion. Knowledge scores above the median for non-parametric data or above the mean for parametric data were classified as ‘good’ or ‘poor’. Chi square tests assessed associations between confidence and knowledge scores. Results: While many of the 37 participants reported reading the guidelines, there was limited awareness of their scope and clinical application; that there is no legal duty to warn; and that the threat does not need to be imminent to warrant disclosure. No association between confidence and ‘good’ theoretical or applied clinical knowledge was identified. Uncertainty of their professional responsibility was identified and in the several case examples of active non-disclosure that were reported this uncertainty reflected the need for further understanding of the guidelines in regard to the processes required before disclosure was initiated. Conclusions: There is a need for further education and training about the guidelines associated with the legislation that would be relevant to support disclosure. The findings may inform future strategies to support introduction of policy changes in other jurisdictions where similar regulatory regimes are introduced. (shrink)

In the article by Kristin Voigt in the April 2013 issue of Cambridge Quarterly of Healthcare Ethics, quotation marks around certain phrases were deleted.

Entry for the Stanford Encylcopedia of Philosophy.

Building on existing studies suggesting that corporate social performance (CSP) is important in the job choice process, the authors investigate job seekers’perceptions of importance of CSP and explore effects of CSP dimensions on organizational attractiveness. Job seekers consider CSP important to assessment of firms and rate five specific CSP dimensions (environment, community relations, employee relations, diversity, and product issues) as more important than six other CSP dimensions. Using signaling theory and social identity theory, the authors hypothesize differences in effects of (...) CSP data on ratings of employer attractiveness and find that environment, community relations, and diversity dimensions have the largest affect on attractiveness ratings. (shrink)

I suggest a pluralistic account of folk psychology according to which not all predictions or explanations rely on the attribution of mental states, and not all intentional actions are explained by mental states. This view of folk psychology is supported by research in developmental and social psychology. It is well known that people use personality traits to predict behavior. I argue that trait attribution is not shorthand for mental state attributions, since traits are not identical to beliefs or desires, and (...) an understanding of belief or desire is not necessary for using trait attributions. In addition, we sometimes predict and explain behavior through appeal to personality traits that the target wouldn't endorse, and so could not serve as the target's reasons. I conclude by suggesting that our folk psychology includes the notion that some behavior is explained by personality traits—who the person is—rather than by beliefs and desires—what the person thinks. Consequences of this view for the debate between simulation theory and theory theory, as well as the debate on chimpanzee theory of mind are discussed. (shrink)

Philosophy Compass, Volume 17, Issue 6, June 2022.

The article examines how some culturally shared and corporeally enacted beliefs and norms about sexed and racialized embodiment can form embodied agency, and this with the aid of the concepts of incorporation and excorporation. It discusses how the phenomenological concept of excorporation can help us examine painful experiences of how one's lived body breaks in the encounter with others. The article also examines how a continuous excorporation can result in bodily alienation, and what embodied resistance can mean when one has (...) undergone or undergoes excorporation. Elaborating on the work of, among others, Maurice Merleau-Ponty, Martin Heidegger, Drew Leder, and Sarah Ahmed, I discuss incorporation and excorporation of beliefs and norms regarding sexual difference, such as beliefs and norms regarding female and male embodiment, through a reading of Jeffrey Eugenides' novel Middlesex. I also suggest that it is useful to understand the postcolonial scholar Frantz Fanon's narrative of how he could not but attend to his own skin color while living in France in the 1940s and 1950s, in terms of excorporation. Whereas these are different narratives in many ways, I regard them as helpful for clarifying what excorporation implies and what analytic work this concept can enable. (shrink)

To answer tantalizing questions such as whether animals are moral or how morality evolved, I propose starting with a somewhat less fraught question: do animals have normative cognition? Recent psychological research suggests that normative thinking, or ought-thought, begins early in human development. Recent philosophical research suggests that folk psychology is grounded in normative thought. Recent primatology research finds evidence of sophisticated cultural and social learning capacities in great apes. Drawing on these three literatures, I argue that the human variety of (...) social cognition and moral cognition encompass the same cognitive capacities and that the nonhuman great apes may also be normative beings. To make this argument, I develop an account of animal social norms that shares key properties with Cristina Bicchieri's account of social norms but which lowers the cognitive requirements for having a social norm. I propose a set of four early developing prerequisites implicated in social cognition that make up what I call naïve normativity: the ability to identify agents, sensitivity to in-group/out-group differences, the capacity for social learning of group traditions, and responsiveness to appropriateness. I review the ape cognition literature and present preliminary empirical evidence supporting the existence of social norms and naïve normativity in great apes. While there is more empirical work to be done, I hope to have offered a framework for studying normativity in other species, and I conclude that we should be open to the possibility that normative cognition is yet another ancient cognitive endowment that is not human-unique. (shrink)

Death concept, death definition, death criterion and death test pluralism has been described by some as a problematic approach. Others have claimed it to be a promising way forward within modern pluralistic societies. This article describes the New Jersey Death Definition Law and the Japanese Transplantation Law. Both of these laws allow for more than one death concept within a single legal system. The article discusses a philosophical basis for these laws starting from John Rawls' understanding of comprehensive doctrines, reasonable (...) pluralism and overlapping consensus. It argues for the view that a certain legal pluralism in areas of disputed metaphysical, philosophical and/or religious questions should be allowed, as long as the disputed questions concern the individual and the resulting policy, law or acts based on the policy/law, do not harm the lives of other individuals to an intolerable extent. However, while this death concept, death definition, death criterion and death test pluralism solves some problems, it creates others. (shrink)

Derk Pereboom's Four-Case Argument is among the most famous and resilient manipulation arguments against compatibilism. I contend that its resilience is not a function of the argument's soundness but, rather, the ill-gotten gain from an ambiguity in the description of the causal relations found in the argument's foundational case. I expose this crucial ambiguity and suggest that a dilemma faces anyone hoping to resolve it. After a thorough search for an interpretation which avoids both horns of this dilemma, I conclude (...) that none is available. Rather, every metaphysically coherent interpretation invites either a hard- or soft-line reply to Pereboom's argument. I then consider a recharacterization of the dilemma which seems to clear the way for the defence of a revised Four-Case Argument. I address this rejoinder by identifying a still more fundamental problem shared by all viable interpretations of the manipulation cases, showing that each involves a type of manipulation which undermines the victim's agency. Because this diagnosis supports a soft-line reply to every viable interpretation of the argument and can be endorsed by any compatibilist, I consider it the final piece of the Soft-line Solution to the Four-Case Argument. Finally, I suggest a new taxonomy of manipulation arguments, arguing that none that employs the suppressive variety of manipulation found in Pereboom's argument offers a threat to compatibilism. -/- (For direct download option, search Kristin M. Mickelson, Soft-line Solution). (shrink)

The influence of pervasive cultural norms on people’s actions constitutes a longstanding problem for autonomy theory. On the one hand, such norms often seem to elude the kind of reflection that autonomous agency requires. On the other hand, they are hardly entirely beyond the pale of autonomy: people do sometimes reflect critically on them and resist them. This paper draws on phenomenological accounts of embodiment in order to reconcile these observations. We suggest that pervasive cultural norms exert a strong and (...) elusive, but occasionally resistible, influence because they are incorporated – they operate on the largely pre-reflective bodily level of human existence. As an illustration we discuss parental decisions about surgery for children born with unclear sex, decisions permeated by deeply entrenched norms about sexual difference and genital appearance. (shrink)

Background How often does refractory suffering, which is suffering due to symptoms that cannot be adequately controlled, occur at the end of life in modern palliative care? What are the causes of such refractory suffering? Should euthanasia be offered for refractory suffering at the end of life? We sought to shed light on these questions through interviews with palliative care specialists. Methods Semi-structured interviews with six nurses and six doctors working in palliative care in five Norwegian hospitals. Transcripts were analysed (...) with systematic text condensation, a qualitative analysis framework. Results Informants find that refractory suffering is rare, and that with palliative sedation satisfactory symptom control can nearly always be achieved at the end of life. However, the process of reaching adequate symptom control can be protracted, and there can be significant suffering in the meantime. Both somatic, psychological, social and existential factors can contribute to refractory suffering and potentiate each other. However, informants also place significant weight on factors pertaining to the organization of palliative care services as contributing to insufficient symptom control. Conclusions If refractory suffering is indeed rare, then this arguably weakens a common prima facie argument for the legalization of assisted dying. However, the process of reaching adequate symptom control can be protracted and involve significant suffering. The experiences of palliative care clinicians constitute important empirical premises for the assisted dying debate. The study points to several areas in which palliative care can be improved. (shrink)

When participants are asked to make sensibility judgments on sentences that describe action toward the body (i.e., “Mark dealt the cards to you”) or away from the body (i.e., “You dealt the cards to Mark”), they are faster to respond when the response requires an arm movement in the same direction as the action described by the sentence. This congruence effect is known as the Action–Sentence Compatibility Effect (ACE). This study reports 4 experiments that extend our understanding of the ACE (...) by exploring how the time at which one prepares the motor response required for the sensibility judgment affects the magnitude of the ACE. Results show that the ACE arises only when participants have the opportunity to plan their motor response while they are processing the sentence. (shrink)

The philosophy of Hans-Georg Gadamer interests a wide audience that spans the traditional distinction between European and Anglo-American philosophy. Yet one of the most important and complex aspects of his work - his engagement with German Idealism - has received comparatively little attention. In this book, Kristin Gjesdal uses a close analysis and critical investigation of Gadamer's Truth and Method to show that his engagement with Kant, Hegel, and Schleiermacher is integral to his conception of hermeneutics. She argues that a (...) failure to engage with this aspect of Gadamer's philosophy leads to a misunderstanding of the most pressing problem of post-Heideggerian hermeneutics: the tension between the commitment to the self-criticism of reason, on the one hand, and the turn towards the meaning-constituting authority of tradition, on the other. Her study provides an illuminating assessment of both the merits and the limitations of Gadamer's thought. (shrink)

How do feminists in the United Kingdom view spirituality and religion? What are their religious and spiritual attitudes, beliefs, and practices? What role do spirituality and religion play in feminists’ lives? This article presents findings from an interview-based study of 30 feminists in England, Scotland, and Wales. It identifies three characteristics of feminists’ approaches to religion and spirituality: They are de-churched, are relational, and emphasize practice. These features warrant a new approach to feminists’ relationships with religion and spirituality. Rather than, (...) as others have done, equating feminism with secularism, secularization, or alternative spiritualities, the article reveals the complex ways feminists forge religio-spiritual lives. The interview data demonstrate that it is unwise to see “spirituality” and “religion” as analytically distinct. Instead, drawing on the growing field of scholarship on “lived religion,” the article proposes conceptualizing feminist spirituality as lived religion. (shrink)

Hard incompatibilism is a view about free will and moral responsibility that has been developed and defended by Derk Pereboom for almost three decades (Pereboom 1995, 2001, 2014). Succinctly put, hard incompatibilists argue that we do not have free will because, whether determinism is true or false, we are subject to the freedom-undermining effects of causal luck (i.e. causal factors beyond our control). In recent years, Gregg Caruso has become a vocal advocate of hard incompatibilism, and he rests his “public (...) health-quarantine model” and its non-retributive approach to criminal behavior squarely on the foundation of Pereboom’s free-will metaphysics (e.g. Caruso 2012, 2014, 2021, 2022; Pereboom and Caruso 2018, 2022; Dennett and Caruso 2021). More recently, biologist and science popularizer Robert Sapolsky has raised the public profile hard incompatibilism by claiming to endorse this position in his best-selling book Determined: A Science of Life Without Free Will (2023). -/- In this book, I offer a refutation of hard incompatibilism and all instances of constructive incompatibilism. In short, I argue that two central central explanatory tenets of hard incompatibilism are in tension with one another, making it impossible for someone to argue for one without undermining their defense of the other in the process. I then point out that the arguments against hard incompatibilism also undermine Neil Levy's luck-pincer impossibilism (2011). Along the way, I explain why Robert Sapolsky is not a hard incompatibilist and is actually committed to the falsity of hard incompatibilism. In closing, I propose a way for skeptics like Caruso and Sapolsky to maintain their skepticism without any type of constructive incompatibilism as the foundation. -/- [Building from the arguments in "The Problem of Free Will: An Abductive Approach", "Free Will, Self-Creation, and The Paradox of Moral Luck," and "(In)compatibilism"] -/- . (shrink)

History shows that legislation can make firms respect their workers’ rights and refrain from victimising them. Given the scale of disregard for workers’ rights around the globe and the absence of a global legislature, should the US step in to protect workforces globally, at least so far as concerns American multinationals? The author is completing her MBA at London Business School and has an American background in accountancy and banking.

This paper is based on the comments I gave to Alfred Mele regarding his original Zygote Argument during my presentation at a small workshop on manipulation arguments in Budapest back in 2012. After those comments, Mele changed the conclusion of his original Zygote Argument (OZA) from a positive, explanatory conclusion to a negative, non-explanatory conclusion--and, correspondingly, redefined 'incompatibilism' so that it would no longer refer in his work to the view that determinism precludes (undermines, eliminates, destroys, etc.) free will, but (...) refers narrowly to the perhaps spurious association claim that appears in the conclusion of the revised Zygote Argument (Mele 2013+). Yet, over the last decade, Mele has made no comment in print about the changes he made, the invalidity objection that led to them, nor to the fact that his revised Zygote Argument was originally presented by me as a (non-optimal) reaction to my invalidity objection to his original Zygote Argument. To my knowledge, Mele has only mentioned this 2015 paper once, at it was not in the context of understanding manipulation arguments; it was, rather, in the context of defending his revised, non-explanatory definition of 'incompatibilism' at the opening of Aspects of Agency (p. 6, n. 4). There, Mele singles out *just this 2015 paper* as a place where they'll find what Mele degrades as a type of nonstandard/nontraditional definition of 'incompatibilism' that he rejects. This is notable because Mele provides no empirical evidence that his preferred definition is standard, and most (including Lehrer, who coined the term) reject the negative, non-explanatory, association-based definition that Mele came to endorse in the aftermath of my invalidity objection to OZA. So, if Mele had a genuine concern about philosophers who use the term 'incompatibilism', then Mele could have--and should have--named almost any leading figure in free will for this purpose (since most--including Pereboom, Vihvelin, Haji, etc.) reject the non-explanatory definition that Mele-2013+ now endorses. Yet, for untold reasons, Mele isolated the working definition of 'incompatibilism' used in one paper by one unemployed junior researcher to use as his example--even though Neil Levy had used this same definition in previously published work (eg. Levy 2011). Moreover, if Mele were genuinely interested in helping his readers understand the ambiguity of terms like 'compatibilism' and 'incompatibilism' it is a mystery that he referenced a paper in which nothing of substance hung on the definitions given to these terms -- especially considering that he might have instead pointed them to my OTHER 2015 paper, "A Critique of Vihvelin's Three-Fold Classification" in which the MAIN AIM of the paper is to expose the difficulties facing anyone who wants to define the terms 'compatibilism' and 'incompatibilism' in a way that everyone will accept (including a critique of the negative, non-explanatory "incompossibilist" definition that Mele adopted after my objection to OZA). By all appearances, Mele's main aim in citing specifically THIS paper and none of my other work was to give readers the false impression that my working definition of 'incompatibilism' played some role in my charge that his argument is invalid (which it doesn't, given that the term doesn't appear in either the premises or conclusion of that argument). Mele adds to this unseemly rhetorical campaign in his book *Manipulation Agents* where he mentions an invalidity objection in the intro (p. 84) and then discusses that objection in the final lines of Chapter 5 of the book (p. 120-121). The invalidity objection discussed here is completely pedantic, has never been seriously raised in the primary literature (and was previously addressed in multiple places my multiple philosophers, including me), and has nothing whatever to do with my invalidity objection. In other words, Mele was content to discuss an invalidity objection that no one has ever had to an argument that is clearly valid while completely ignoring the ONLY substantive invalidity objection to his argument in print. This is unfortunate, because it has led to serious confusion --including the patently false description of my invalidity objection to OZA as an objection to the revised version of the Zygote Argument that Mele adopted in *response* my objection (e.g., Capes mistakenly claims "Mickelson (2015) contends that arguments like this [i.e. like the revised Zygote Argument] are invalid. But that’s because she defines “incompatibilism” differently than I’ve defined it here" in his "Manipulation Arguments and Direct Arguments" chapter in the 2023 Wiley-Blackwell Companion to Free Will; I did not say this, and the definition of 'incompatibilism' is irrelevant to my objection). In "The Zygote Argument Is Invalid--Now What?", I simply use the invalidity of the simple 2-premise Zygote Argument as a foil to make a series of more philosophically significant points (e.g. regarding the dialectical structure of the free-will debate, the role of best-explanation reasoning, and to develop the first-ever "master manipulation argument"). Mele has yet to address my reasons for calling attention to the non-trivial invalidity of his OZA or to any of my answers to the "Now What?" question in this paper, even though this question and my proposed answers to this question are the paper's main point. For those interested in a more recent discussion of how the logical and metaphilosophical observations made in this "Now What?" paper have helped to move the free-will debate forward, I suggest looking at the discussions of the "paradigm shift" in the free-will debate that helps to explain why the free-will debate has become mired in stalemates and empty verbal disputes that are found, for example, in my contributions to the Wiley-Blackwell Companion to Free Will (Intro and Chapter 4, 2023) and my paper "Free Will, Self-Creation, and the Paradox of Moral Luck" (2019). (shrink)

With pre-implantation genetic diagnosis (PGD), genetic testing and selective transfer of embryos is possible. In the future, germ-line gene therapy (GLGT) applied to embryos before implantation, in order to introduce missing genes or replace mutant ones, may be possible. The objective of this dissertation is to analyse moral aspects of these technologies, as described by eighteen British, Italian and Swedish gynaecologists and geneticists. The objective is systematised into three parts: research interviews and qualitative analysis, philosophical analysis, and elaboration of a (...) framework that supports the combination of analytic methods. PGD was described as positive since it enabled some couples at risk for a genetic disease to have a child without the disease. PGD was described as in different senses ‘better’ than methods for prenatal diagnosis and selective termination of pregnancy. It was also described as positive since it provided couples at risk with one more option, even if it did not result in the birth of a healthy child. However, interviewees were concerned about the difficulty of defining and evaluating genetic disease. They were also concerned about patients’ choices, and about exaggerated use or misuse. Whereas PGD gave rise to ambivalence in terms of how to understand, describe and evaluate it, GLGT was often described as unrealistic or undesirable. The results of the qualitative analysis are used in a philosophical analysis of the concepts of choice, autonomous choice, ambivalence, trust and ambivalence in trust relations. A set of distinct characteristics of each concept are elaborated. The results of the philosophical analysis are used in the discussion of the results of the qualitative analysis. The study shows that the technologies imply both ‘new’ ways to perform ‘old’ medical practices and ‘new’ practices. Old moral questions are reformulated. New moral questions are added. Against the background of this, the concept of genetic identity is discussed. Key words: empirical ethics, pre-implantation genetic diagnosis, germ-line gene therapy, qualitative research, philosophical analysis, medical progress, genetic disease, choice, autonomous choice, ambivalence, trust, genetic identity. (shrink)

The notion of individual responsibility has gained prominence in recent debates about health care. First, responsibility has been proposed as a rationing criterion; second, some policies use rewards and sanctions to encourage individuals to ‘take responsibility’ for their health; finally, acting responsibly within the health care system is portrayed as a requirement of reciprocity. The aim of this paper is two-fold. First, I assess these different kinds of appeal to individual responsibility from the perspective of equality. The literature has identified (...) important concerns about equality and fairness with proposals to use individual responsibility as a rationing criterion; I suggest that there are similar concerns about incentive schemes and reciprocity-based appeals to individual responsibility. The analysis will draw on luck egalitarian accounts of equality, which emphasise the importance of individual responsibility. This allows me to pursue the second objective for paper: to reconsider the luck egalitarian perspective on these different appeals to responsibility. Applying the arguments of recent contributions to the luck egalitarian literature to the health arena suggests that luck egalitarians need not support the use of responsibility as a rationing criterion, and they can also identify problems with incentives and reciprocity-based arguments. However, the language of individual responsibility and its prominence in public debates may have implications for individuals’ health and well-being, which raises challenging issues for luck egalitarians as they attempt to apply their theory to the real world. (shrink)

In this paper, we contribute to research on enterprise artificial intelligence (AI), specifically to organizations improving the customer experiences and their internal processes through using the type of AI called machine learning (ML). Many organizations are struggling to get enough value from their AI efforts, and part of this is related to the area of explainability. The need for explainability is especially high in what is called black-box ML models, where decisions are made without anyone understanding how an AI reached (...) a particular decision. This opaqueness creates a user need for explanations. Therefore, researchers and designers create different versions of so-called eXplainable AI (XAI). However, the demands for XAI can reduce the accuracy of the predictions the AI makes, which can reduce the perceived usefulness of the AI solution, which, in turn, reduces the interest in designing the organizational task structure to benefit from the AI solution. Therefore, it is important to ensure that the need for XAI is as low as possible. In this paper, we demonstrate how to achieve this by optimizing the task structure according to sociotechnical systems design principles. Our theoretical contribution is to the underexplored field of the intersection of AI design and organizational design. We find that explainability goals can be divided into two groups, pattern goals and experience goals, and that this division is helpful when defining the design process and the task structure that the AI solution will be used in. Our practical contribution is for AI designers who include organizational designers in their teams, and for organizational designers who answer that challenge. (shrink)

Employees often experience ethical dilemmas throughout their service in an organization. This study utilized a multilevel standpoint to address employees’ differences in ethical reasoning. Hierarchical linear modeling was used to analyze responses from 40,485 full‐time employees across 54 countries. Drawing from Durkheim's concepts of the homo duplex, socialization process, and social conditions, this study found a positive relationship between employees’ income level and unethical reasoning. Furthermore, the results indicate that modern social regulation, technological advancement, economic development, and economic change moderate (...) the relationship between income and ethical judgment. The study findings contribute to the Durkheimian model by validating the effects of individual‐ and country‐level factors on employees’ ethicality. Considering that the results contradict Durkheim's initial propositions, another concept and theory are proposed, which may complement Durkheim's arguments. Practical implications for organizations and society are further discussed to reinforce employees’ ethics. (shrink)

Derk Pereboom's Four-Case Argument is among the most famous and resilient manipulation arguments against compatibilism. I contend that its resilience is not a function of the argument's soundness but, rather, the ill-gotten gain from an ambiguity in the description of the causal relations found in the argument's foundational case. I expose this crucial ambiguity and suggest that a dilemma faces anyone hoping to resolve it. After a thorough search for an interpretation which avoids both horns of this dilemma, I conclude (...) that none is available. Rather, every metaphysically coherent interpretation invites either a hard- or soft-line reply to Pereboom's argument. I then consider a recharacterization of the dilemma which seems to clear the way for the defence of a revised Four-Case Argument. I address this rejoinder by identifying a still more fundamental problem shared by all viable interpretations of the manipulation cases, showing that each involves a type of manipulation which undermines the victim's agency. Because this diagnosis supports a soft-line reply to every viable interpretation of the argument and can be endorsed by any compatibilist, I consider it the final piece of the Soft-line Solution to the Four-Case Argument. Finally, I suggest a new taxonomy of manipulation arguments, arguing that none that employs the suppressive variety of manipulation found in Pereboom's argument offers a threat to compatibilism. (shrink)

The legitimacy of multi-stakeholder initiatives (MSIs) as institutions for social and environmental governance in the global economy has received much scholarly attention over the past years. To date, however, research has yet to focus on assessing the legitimacy of MSIs in their interactions with other actors within larger systems of deliberation. Drawing on the deliberative systems perspective developed within deliberative democracy theory, we theorise a normative framework to evaluate the roles of MSIs within the broader systems of governance they co-construct (...) through their interactions with other initiatives, governments, non-governmental organisations, and other external actors. As we demonstrate in our evaluation of the illustrative case of the Bangladesh Accord on Fire and Building Safety as a MSI in the context of the Bangladeshi garment industry, this framework can help researchers assess whether a MSI ultimately serves to enhance or undermine the deliberative legitimacy of the overall system of which it forms a part. (shrink)

Incentive schemes, which offer recipients benefits if they meet particular requirements, are being used across the world to encourage healthier behaviours. From the perspective of equality, an important concern about such schemes is that since people often do not have equal opportunity to fulfil the stipulated conditions, incentives create opportunity for further unfair advantage. Are incentive schemes that are available only to disadvantaged groups less susceptible to such egalitarian concerns? While targeted schemes may at first glance seem well placed to (...) help improve outcomes among disadvantaged groups and thus reduce inequalities, I argue in this paper that they are susceptible to significant problems. At the same time, incentive schemes may be less problematic when they operate in ways that differ from the ‘standard’ incentive mechanism; I discuss three such mechanisms. (shrink)

As the pressure on available health care resources grows, an increasing moral challenge in intensive care is to secure a fair distribution of nursing care and medical treatment. The aim of this article is to explore how limited resources influence nursing care and medical treatment in intensive care, and to explore whether intensive care unit clinicians use national prioritization criteria in clinical deliberations. The study used a qualitative approach including participant observation and in-depth interviews with intensive care unit physicians and (...) nurses working at the bedside. Scarcity of resources regularly led to suboptimal professional standards of medical treatment and nursing care. The clinicians experienced a rising dilemma in that very ill patients with a low likelihood of survival were given advanced and expensive treatment. The clinicians rarely referred to national priority criteria as a rationale for bedside priorities. Because prioritization was carried out implicitly, and most likely partly without the clinician's conscious awareness, central patient rights such as justice and equality could be at risk. (shrink)

The Global Burden of Disease project quantifies the impact of different health conditions by combining information about morbidity and premature mortality within a single metric, the Disability Adjusted Life Year. One important goal for the GBD project has been to inform decisions about global health priorities. A number of recent studies have used GBD data to argue that global health funding fails to align with the GBD. We argue that these studies’ shared assumption that global health resources should ‘align’ with (...) the burden of disease is unfounded and has troubling implications. First, since the allocation of resources involves difficult trade-offs between different, potentially competing goals, any ‘misalignment’ of allocation and disease burdens need not necessarily indicate that the allocation of funds fails to meet recipient countries’ needs or interests. Second, using alignment as a baseline implicitly makes controversial assumptions about how harms of different magnitudes affecting different numbers of individuals should be aggregated. We discuss two alternative ways in which GBD data could help inform decisions about resource allocation, neither of which gives more than a limited role to GBD data. (shrink)

According to the US National Institute on Aging and the Alzheimer’s Association (NIA-AA), Alzheimer’s disease (AD) should be understood as a biological construct. It can be diagnosed based on AD-characteristic biomarkers only, even if AD biomarkers can be present many years before a person experiences any symptoms of AD. The NIA-AA’s conceptualisation of AD radically challenges past AD conceptualisations. This article offers ananalytic framework for the clarification and analysis of meanings and effects of conceptualisations of diseases such as that of (...) AD. This framework consists of nine questions that allows us to determine how the conceptualisations of diseases, such as that of AD, link or decouple the following terms to/from each other: screening, diagnosis, pathology, disease (along the lines of what have been labelled as “biological-physiological” or “normative” conceptions of disease in philosophy of medicine), symptoms, and illness. It also includes questions regarding how specific decouplings open up for new categories through which people can understand themselves in new ways, and what spaces of possibilities specific conceptualisations (and their decouplings and linkages) open to. The article shows how specific decouplings/linkages can open up not only for the phenomena of pathologisation but also for a distinct, but related phenomenon here termed as diseasisation. (shrink)

Perhaps because both explanation and prediction are key components to understanding, philosophers and psychologists often portray these two abilities as though they arise from the same competence, and sometimes they are taken to be the same competence. When explanation and prediction are associated in this way, they are taken to be two expressions of a single cognitive capacity that differ from one another only pragmatically. If the difference between prediction and explanation of human behavior is merely pragmatic, then anytime I (...) predict someone’s future behavior, I would at that moment also have an explanation of the behavior. I argue that advocates of both the theory theory and the simulation theory accept the symmetry of psychological prediction and explanation. However, there is very good reason to believe that this hypothesis is false. Just as we can predict the occurrence of some physical phenomena that we have no explanation for, we are also able to make accurate predictions of intentional behavior without having an explanation. Rather than requiring mental state attribution, I argue that the prediction of human behavior is most often accomplished by statistical induction rather than through an appeal to mental states. However, explanations are not given in these terms. (shrink)

The acknowledgement of basic human vulnerability in relationships between mental health service users and professionals working in community-based mental health services (in Norway) was a starting point. The purpose was to explore how users of these services describe and make sense of their meetings with other people. The research is collaborative, with researcher and person with experienced-based knowledge cooperating through the research process. Data is derived from 19 interviews with 11 people who depend on mental health services for assistance at (...) least three times a week. Data is analysed according to the Interpretative Phenomenological Analysis (IPA). Results confirm that reciprocity is fundamental for relationships, and that recognizing the individual entails personal involvement. The participants describe a struggle, and recognizing this struggle may help the professional to achieve a deeper understanding of the individual. (shrink)

Free-will incompatibilism has become a motte-and-bailey doctrine (Shackel 2014), and is currently being maintained by standard motte-and-bailey strategies. In this paper, I explain why incompatibilism has a motte-and-bailey structure and why philosophers who do not aim to dismantle it are complicit in both the maintenance of this problematic doctrine and the normalization of a host of bad practices engaged in by those who actively exploit it. To solidify the diagnosis, I provide a paradigmatic motte-and-baileying case that has been ongoing for (...) over a decade. Specifically, I discuss how motte-and-baileying has generated widespread confusion surrounding the logical structure and conclusion of manipulation arguments. Even more specifically, I look at Mele's so-called "Zygote Argument for incompatibilism". I point out that Mele currently conflates under two distinct arguments with different logical forms and substantively different conclusions under that heading, and explain how this has needlessly impeded progress in the free-will debate. The original variant of the Zygote Argument was invalid because it aimed to establish that determinism precludes (destroys, undermines, is antagonistic to) free will, but its supported a far weaker non-explanatory conclusion. In direct response to this invalidity objection, Mele took his critic's suggestion to change the conclusion of his argument to the thesis that free will and determinism are perhaps spuriously associated -- but he also covertly changed his preferred definition of 'incompatibilism' to pick out the non-explanatory conclusion of the new variant of the Zygote Argument which allowed him to continue speaking AS IF his argument was still an argument for incompatibilism according to his original definition of 'incompatibilism'. It is not simply that Mele made these changes or that he failed to mention in print that he made them (despite having over a decade to do so), but that he has actively attempted to discredit his critics by insisting--contrary to fact--that those who do not use his negative definition of 'incompatibilism' are using the term in a nonstandard and nontraditional way that he has "never had any use for" and there is some kind of connection (which he does describe) between the invalidity objection to his original argument that the definition of 'incompatibilism' one prefers. Oddly, Mele has mentioned only one "invalidity objection" in print, but this objection is direct at the revised Zygote Argument--even though no one had ever pressed an invalidity objection to his new argument (the form of which is patently valid). As a direct result of Mele's evasive behaviors (covertly redefining jargon to cover changes to the form/conclusion of his argument), many people--including Mele's own former graduate students--have published articles in which they fail to recognize that Mele changed his argument and redefined terms, thereby perpetuating the false narrative that the new Zygote Argument has the same "incompatibilist" conclusion as the original (which, notably, had the same conclusion as its predecessor, Pereboom's Four-Case Argument). Moreover, Mele has not even ONCE corrected those who "misdescribe" his revised argument as concluding that determinism is antagonstic to (precludes, undermines, rules out, etc.) free will. For example, Mele never corrects those who mistakenly claim that the revised Zygote Argument has the same "incompatibilist" conclusion as Pereboom's, nor has Mele ever mentioned that he now defines the term 'incompatibilism' differently than Pereboom--since Pereboom since uses this term to refer to the explanatory conclusion of the original Zygote Argument, which had the same explanatory conclusion of his Four-Case Argument. To further throttle his critics, Mele has obliquely suggested that the invalidity objection to his original Zygote Argument works only if one accepts his critic's idiosyncratic definition of 'incompatibilism' -- a patently false charge (since the term 'incompatibilism' doesn't even appear in his arguments) and one that has needlessly confused his audience. Indeed, other philosophers have now made this false and quite indefensible accusation explicitly in print, thereby helping Mele and others to continue motte-and-baileying with impunity. I close by preemptively responding to strategies commonly used by motte-and-bailey apologists to suppress legitimate criticisms of their equivocation and well-poisoning strategies (e.g. "Philosophers are allowed to define their technical terms however they like" and "the motte/bailey divide is a distinction without a difference") which have hitherto kept their philosophical audience from participating in a legitimate discussion about why tracking the distinction between the the "motte" thesis (a negative, arguably spurious association claim) and the "bailey" thesis (a positive explanatory claim) is not trivial, but is instead one that is absolutely essential to making progress in the free-will debate. Of course, a single critic cannot (almost by definition) undermine a motte-and-bailey doctrine once it has been established. As such, even if every diagnosis in this essay is accurate, it will not change the discourse. The motte-and-baileying will continue, and the debate will remain in needless deadlock, until a critical threshold of OBSERVERS learn about the motte/bailey distinction and ask apologists for motte-and-bailey incompatibilism to stop their motte-and-baileying. -/- Manuscript available upon request, plz gmail me: kristin.mickelson.42@. (shrink)

Academic integrity establishes a code of ethics that transfers over into the job force and is a critical characteristic in scientists in the twenty-first century. A student’s perception of cheating is influenced by both internal and external factors that develop and change through time. For students, the COVID-19 pandemic shrank their academic and social environments onto a computer screen. We surveyed science students in the United States at the end of their first COVID-interrupted semester to understand how and why they (...) believed their peers were cheating more online during a pandemic. Almost 81% of students indicated that they believed cheating occurred more frequently online than in-person. When explaining why they believed this, students touched on proctoring, cheating influences, and extenuating circumstances due to COVID-19. When describing how they believed cheating occurred more frequently online, students touched on methods for cheating and surreptitious behavior. The student reasonings were associated with four theories that have been used to examine academic dishonesty. Our results can aid institutions in efforts to quell student concerns about their peers cheating during emergencies. Interestingly, most student beliefs were mapped to planned behavior theory while only a few students were mapped to neutralization theory, suggesting it was a novel modality of assessment rather than a pandemic that shaped student perceptions. (shrink)

Frans de Waal (1948-2024) transformed our understanding of primate cognition and social behavior, shaping the perspectives of scientists, philosophers, and the general public through his groundbreaking research and engaging popular books.

Birch sketches out an ingenious account of how the psychology of social norms emerged from individual-level norms of skill. We suggest that these individual-level norms of skill are likely to be much more widespread than Birch suggests, extending deeper into the hominid lineage, across modern great ape species, all the way to distantly related creatures like honeybees. This suggests that there would have been multiple opportunities for social norms to emerge from skill norms in human prehistory.