Making good decisions in extremely complex and difficult processes and situations has always been both a key task as well as a challenge in the clinic and has led to a large amount of clinical, legal and ethical routines, protocols and reflections in order to guarantee fair, participatory and up-to-date pathways for clinical decision-making. Nevertheless, the complexity of processes and physical phenomena, time as well as economic constraints and not least further endeavours as well as achievements in medicine and healthcare (...) continuously raise the need to evaluate and to improve clinical decision-making. This article scrutinises if and how clinical decision-making processes are challenged by the rise of so-called artificial intelligence-driven decision support systems (AI-DSS). In a first step, this article analyses how the rise of AI-DSS will affect and transform the modes of interaction between different agents in the clinic. In a second step, we point out how these changing modes of interaction also imply shifts in the conditions of trustworthiness, epistemic challenges regarding transparency, the underlying normative concepts of agency and its embedding into concrete contexts of deployment and, finally, the consequences for (possible) ascriptions of responsibility. Third, we draw first conclusions for further steps regarding a ‘meaningful human control’ of clinical AI-DSS. (shrink)

Artificial intelligence (AI) systems are increasingly being used in healthcare, thanks to the high level of performance that these systems have proven to deliver. So far, clinical applications have focused on diagnosis and on prediction of outcomes. It is less clear in what way AI can or should support complex clinical decisions that crucially depend on patient preferences. In this paper, we focus on the ethical questions arising from the design, development and deployment of AI systems to support decision-making around (...) cardiopulmonary resuscitation and the determination of a patient’s Do Not Attempt to Resuscitate status (also known as code status). The COVID-19 pandemic has made us keenly aware of the difficulties physicians encounter when they have to act quickly in stressful situations without knowing what their patient would have wanted. We discuss the results of an interview study conducted with healthcare professionals in a university hospital aimed at understanding the status quo of resuscitation decision processes while exploring a potential role for AI systems in decision-making around code status. Our data suggest that (1) current practices are fraught with challenges such as insufficient knowledge regarding patient preferences, time pressure and personal bias guiding care considerations and (2) there is considerable openness among clinicians to consider the use of AI-based decision support. We suggest a model for how AI can contribute to improve decision-making around resuscitation and propose a set of ethically relevant preconditions—conceptual, methodological and procedural—that need to be considered in further development and implementation efforts. (shrink)

Background: In modern healthcare, the role of solidarity, altruism and the natural response to moral challenges in life-threatening situations is still rather unexplored. The COVID-19 pandemic provided an opportunity to obtain a deeper understanding of nurses’ willingness to care for patients during crisis. Objective: To elucidate clinical expressions of ontological situational ethics through nurses’ willingness to work during a pandemic. Research design, participants and context: A qualitative study with an interpretive design was applied. Twenty nurses who worked in intensive care (...) unit at two Swedish hospitals during the first, second, and third waves of the COVID-19 pandemic were interviewed. The analysis was interpretative and applied a theoretical ethics perspective. Ethical considerations: The study was approved by the Swedish Ethical Review Authority and informed consent was obtained from all participants. Findings: From a philosophical perspective, the nurses expressed sovereign life expressions of mercy and compassion, which arose spontaneously in response to seeing vulnerable fellow humans. They referenced ‘‘the nurse inside me’’ and their choice of profession as motives to provide care. Ontological situational ethics in culture and norms were noted in the constructs of competence, responsibility, solidarity with colleagues and organization; and interest and learning were driving forces. Ethical demand was evident when nurses expressed ideas of meaningfulness in helping their fellow humans; but themes of ambiguity, exhaustion and unwillingness were also present. Conclusions: The nurses showed a high willingness to care for patients during a crisis. Responding to the ethical demand and to care for vulnerable human beings while risking their own health and lives could be interpreted as an inter-human vocation. These spontaneous altruistic actions saved the lives of many patients during the pandemic and need to be understood and supported. (shrink)

BackgroundThe need for an ethical debate about the use of coercion in intensive care units (ICU) may not be as obvious as in other areas of medicine, such as psychiatry. Coercive measures are often necessary to treat critically ill patients in the ICU. It is nevertheless important to keep these measures to a minimum in order to respect the dignity of patients and the cohesion of the clinical team. A deeper understanding of what patients and their relatives perceive during their (...) ICU stay will shed different light on intensive care management. Patients' experiences of loss of control, dependency and abandonment may lead to a new approach towards a broader approach to the concept of coercion in intensive care. The aim of our research is to explore the experiences of patients and relatives in the ICU and to determine when it might be possible to reduce feelings and memories of coercion.MethodsWe conducted and analysed 29 semi-structured interviews with patients and relatives who had been in the ICU a few months previously. Following a coding and categorisation process in MAXQDA™, a rigorous qualitative methodology was used to identify themes relevant to our research.ResultsFive main themes emerged: memory issues; interviewees’ experiences of restricting measures and coercive treatment; patients’ negative perception of situational and relational dependency with the risk of informal coercion; patients’ perceptions of good care in a context of perceived dependency; progression from perception of coercion and dependency to respect for the person. All patients were grateful to have survived. However, coercion in the form of restraint, restriction of movement, and coercive treatment in the ICU was also acknowledged by patients and relatives. These included elements of informal coercion beyond restraints, such as a perceived negative sense of dependence, surrender, and asymmetrical interaction between the patient and health providers.ConclusionsTo capture the full range of patients' experiences of coercion, it is necessary to expand the concept of coercion to include less obvious forms of informal coercion that may occur in dependency situations. This will help identify solutions to avoid or reduce negative recollections that may persist long after discharge and negatively affect the patients' quality of life. (shrink)

Emotions are a core factor of learning. Studies have shown that multiple emotions are co-experienced during learning and have a significant impact on learning outcomes. The present study investigated the importance of multiple, co-occurring emotions during learning about human biology with MetaTutor, a hypermedia-based intelligent tutoring system. Person-centered as well as variable-centered approaches of cluster analyses were used to identify emotion clusters. The person-centered clustering analyses indicated three emotion profiles: a positive, negative and neutral profile. Students with a negative profile (...) learned less than those with other profiles and also reported less usage of emotion regulation strategies. Emotion clusters identified through spectral co-clustering confirmed these results. Throughout the learning activity, emotions built a stable correlational structure of a positive, a negative, a neutral and a boredom emotion cluster. Positive emotion cluster scores before the learning activity and negative emotion cluster scores during the learning activity predicted learning, but not consistently. These results reveal the importance of negative emotions during learning with MetaTutor. Potential moderating factors and implications for the design and development of educational interventions that target emotions and emotion regulation with digital learning environments are discussed. (shrink)

Conservation can occur anywhere regardless of scale, political jurisdiction, or landownership. We present a framework to help managers at protected areas practice conservation at the scale of relationships. We focus on relationships between stakeholders and protected areas and between managers and other stakeholders. We provide a synthesis of key natural resources literature and present a case example to support our premise and recommendations. The purpose is 4-fold: 1) discuss challenges and threats to conservation and protected areas; 2) outline a relationship-scale (...) approach to address conservation threats; 3) describe the tools and techniques that can be used to implement this approach; and 4) present a case example from rural Alaska, USA, to illustrate relationship-scale conservation. Our case example illustrates how aspects of this approach to conservation were applied to address a wildlife population decline. Tools needed to implement relationship-scale conservation include 1) collecting and documenting narratives of place; 2) measuring and monitoring trust and commitment; and 3) identifying and mitigating threats. We recommend that planners and managers, working with their research partners, redefine and refocus their goals and objectives to include these practices. Doing so will enable them to gain substantial applied knowledge about their stakeholders and foster and maintain place relationships as desired outcomes of conservation. The ultimate outcome is a better prognosis for long-term global survival of protected areas and biodiversity. Published 2014. This article is a U.S. Government work and is in the public domain in the USA. (shrink)

While many theories exist to explain the complexity of environmental behaviour, the role of individuals’ relationship with nature has not yet been fully clarified. This paper attempts to operationalise human-nature relationships. It expands upon a scale assessed by an iterative process of mixed methods in the US and Europe. This scale is then used to assess individuals’ relationship with nature, and whether such relationships correlate with environmental behaviour. The value scale of Schwartz's Theory of Basic Values is used to validate (...) the results. The results verify that people hold multiple human-nature relationships, confirm strong correlations between human-nature relationships and values, and reveal that individuals’ behaviour is connected to the relationship they have with nature. (shrink)

Climate change and decarbonization raise complex justice questions that researchers and policymakers must address. The distributions of greenhouse gas emissions rights and mitigation efforts have dominated justice discourses within scenario research, an integrative element of the IPCC. However, the space of justice considerations is much larger. At present, there is no consistent approach to comprehensively incorporate and examine justice considerations. Here we propose a conceptual framework grounded in philosophical theory for this purpose. We apply this framework to climate mitigation scenarios (...) literature as proof of concept, enabling a more holistic and multidimensional investigation of justice. We identify areas of future research, including new metrics of service provisioning essential for human well-being. [Can be freely read by clicking the ReadCube link below.]. (shrink)

This Correspondence argues in response to Coolsaet et al. (2024) that there is an important role to play for stance-independent justice discussions that are not tied to specific social, political or critical perspectives. These can be valuable for climate research audiences, but also as a basis upon which to critically debate and research injustices.

ZusammenfassungIm Rahmen des Modellvorhabens „Patienten als Partner—Tumorpatienten und ihr Mitwirken bei medizinischen Entscheidungen“ wurden zwischen März 2002 und August 2003 272 palliativ behandelte Tumorpatienten nach ihrer Einstellung zur Patientenverfügung und zur gewünschten Beteiligung an medizinischen Entscheidungen befragt. Von den Befragten kannten 30% Patientenverfügungen nicht, darunter signifikant mehr Befragte mit formal niedrigerem Bildungsabschluss. Es hatten bereits 11% eine Patientenverfügung abgeschlossen, 22% wollten wahrscheinlich eine abschließen, und 30% wollten keine abschließen. Es fand sich ein statistisch signifikanter Zusammenhang zwischen dem Abschluss einer Patientenverfügung (...) und dem Wunsch nach mehr eigener Entscheidungsverantwortung. Die Einstellung zur Patientenverfügung und der Wunsch nach partizipativer Entscheidungsfindung stehen in keinem statistisch signifikanten Zusammenhang. Patienten mit schriftlichen Vorausverfügungen haben einen erhöhten Kommunikations- und Rückkopplungsbedarf, auf den Ärzte sensibel eingehen sollten. Bei der Information über Patientenverfügungen sollten Menschen mit niedrigerem Bildungsstand mehr als bisher berücksichtigt werden. (shrink)

The ability to learn sequential contingencies of actions for predicting future outcomes is indispensable for flexible behavior in many daily decision-making contexts. It remains open whether such ability may be enhanced by transcranial direct current stimulation. The present study combined tDCS with functional near-infrared spectroscopy to investigate potential tDCS-induced effects on sequential decision-making and the neural mechanisms underlying such modulations. Offline tDCS and sham stimulation were applied over the left and right dorsolateral prefrontal cortex in young male adults in a (...) double-blind between-subject design using a three-state Markov decision task. The results showed an enhanced dlPFC hemodynamic response during the acquisition of sequential state transitions that is consistent with the findings from a previous functional magnetic resonance imaging study; a tDCS-induced increase of the hemodynamic response in the dlPFC, but without accompanying performance-enhancing effects at the behavioral level; and a greater tDCS-induced upregulation of hemodynamic responses in the delayed reward condition that seems to be associated with faster decision speed. Taken together, these findings provide empirical evidence for fNIRS as a suitable method for investigating hemodynamic correlates of sequential decision-making as well as functional brain correlates underlying tDCS-induced modulation. Future research with larger sample sizes for carrying out subgroup analysis is necessary in order to decipher interindividual differences in tDCS-induced effects on sequential decision-making process at the behavioral and brain levels. (shrink)

Interdisciplinary research needs innovation. As an action-oriented intervention, this Manifesto begins from the authors’ experiences as social scientists working within interdisciplinary science and technology collaborations in agriculture and food. We draw from these experiences to: 1) explain what social scientists contribute to interdisciplinary agri-food tech collaborations; (2) describe barriers to substantive and meaningful collaboration; and (3) propose ways to overcome these barriers. We encourage funding bodies to develop mechanisms that ensure funded projects respect the integrity of social science expertise and (...) incorporate its insights. We also call for the integration of social scientific questions and methods in interdisciplinary projects from the outset, and for a genuine curiosity on the part of STEM and social science researchers alike about the knowledge and skills each of us has to offer. We contend that cultivating such integration and curiosity within interdisciplinary collaborations will make them more enriching for all researchers involved, and more likely to generate socially beneficial outcomes. (shrink)

Analyzes the origin, structure and resolution of Kant's antinomies of reason from a systematic rather than a historical perspective, exploring the relationship between the theoretical antinomies and the practical antinomy in order to indicate their similarities and differences and to suggest the dependence of the latter on the former.

This study investigates the increased commercialization of African indigenous vegetables (AIV)—former subsistence crops such as African nightshade, cowpea leaves and amaranth species grown mainly by women—from a feminist economics perspective. The study aims to answer the following research question: How does AIV commercialization affect the gendered division of labor, women’s participation in agricultural labor, their decision-making power, and their access to resources? We analyze commercialization’s effects on gender relations in labor and decision-making power and also highlight women’s agency. Based on (...) a mixed method design and analyzing household-level panel data and qualitative focus groups from Kenya, we observe an economic empowerment of women that we relate to women’s individual and collective strategies as well as their retention of control over AIV selling and profits. Yet, while we see economic empowerment of women through commercialization—how they broaden their scope of action and are empowered by generating revenue—that does not contribute to a redistribution of labor or land rights, which are key for gender equality, instead it increases women’s labor burden. (shrink)

Scholarship flourishes in inclusive environments where open deliberations and generative feedback expand both individual and collective thinking. Many researchers, however, have limited access to such settings, and most conventional academic conferences fall short of promises to provide them. We have written this Field Report to share our methods for cultivating a vibrant intellectual community within the Science and Technology Studies Food and Agriculture Network (STSFAN). This is paired with insights from 21 network members on aspects that have allowed STSFAN to (...) thrive, even amid a global pandemic. Our hope is that these insights will encourage others to cultivate their own intellectual communities, where they too can receive the support they need to deepen their scholarship and strengthen their intellectual relationships. (shrink)

As we experience and manipulate time—be it as boredom or impatience—it becomes an object: something materialized and social, something that affects perception, or something that may motivate reconsideration and change. The editors and contributors to this important new book, _Ethnographies of Youth and Temporality, _have provided a diverse collection of ethnographic studies and theoretical explorations of youth experiencing time in a variety of contemporary socio-cultural settings. The essays in this volume focus on time as an external and often troubling factor (...) in young people’s lives, and shows how emotional unrest and violence but also creativity and hope are responses to troubling times. The chapters discuss notions of time and its and its “objectification” in diverse locales including the Georgian Republic, Brazil, Denmark and Uganda. Based on long-term ethnographic fieldwork, the essays in _Ethnographies of Youth and Temporality_ use youth as a prism to understand time and its subjective experience. In the series _Global Youth_, edited by Craig Jeffrey and Jane Dyson. (shrink)

The aim of this study was to investigate the consistency between the self-reports and teacher ratings of students’ emotional and social inclusion at school as well as for their academic self-concept. The German version of the Perceptions of Inclusion Questionnaire (PIQ) was administered to 329 grade 8 students (50.8% female, Mage = 14.5 years, SDage = 0.5 years) and their teachers. First, the three-dimensional structure of both PIQ versions was confirmed by confirmatory item factor analysis. The  and  coefficients (...) demonstrated good reliability for all scales. Second, a correlated trait-correlated method minus one model provided evidence that the method-specificity of teacher ratings was larger than the consistency between the self-reports and teacher ratings. Third, the results of a latent difference model indicated that general method effects can partly be explained by a student’s gender or special educational needs. Finally, the low consistency between self-reports and teacher rating is discussed. (shrink)

This study investigated the effect of stroking vs. simple human presence on later reactions of dairy cows to routine veterinary handling. While in two groups of cows the experimenter stroked the ventral part of the neck or the withers for three consecutive weeks, the third group was exposed to close visual presence. After the treatment period the cows were subjected to rectal palpation. The three groups differed significantly in stepping during rectal palpation, which occurred less often in Neck- and Withers-animals (...) than in control animals. Heart rate increase was significantly higher in the control group than in the two stroking groups. Previous stroking led to fewer stress reactions during the rectal palpation, possibly due to a combined effect of improved relationship towards and thus perception of humans and lasting anti-stress effects of tactile stimulation. Keywords: cattle; tactile stimulation; human–animal relationship; animal welfare. (shrink)

The quality of the animal-human relationship and, consequently, the welfare of animals can be improved by gentle interactions such as stroking and talking. The perception of different stimuli during these interactions likely plays a key role in their emotional experience, but studies are scarce. During experiments, the standardization of verbal stimuli could be increased by using a recording. However, the use of a playback might influence the perception differently than ‘live’ talking, which is closer to on-farm practice. Thus, we compared (...) heifers’ (n = 28) reactions to stroking while an experimenter was talking soothingly (‘live’) or while a recording of the experimenter talking soothingly was played (‘playback’). Each animal was tested three times per condition and each trial comprised three phases: pre-stimulus, stimulus (stroking and talking) and post-stimulus. In both conditions, similar phrases with positive content were spoken calmly, using long low-pitched vowels. All tests were video recorded and analyzed for behaviors associated with different affective states. Effects on the heifers’ cardiac parameters were assessed using analysis of heart rate variability. Independently of the auditory stimuli, longer durations of neck stretching occurred during stroking, supporting our hypothesis of a positive perception of stroking. Observation of ear positions revealed longer durations of the back up position and less ear flicking and changes of ear positions during stroking. The predicted decrease in HR during stroking was not confirmed; instead we found a slightly increased mean HR during stroking with a subsequent decrease in HR, which was stronger after stroking with live talking. In combination with differences in HRV parameters, our findings suggest that live talking might have been more pleasurable to the animals and had a stronger relaxing effect than ‘playback’. The results regarding the effects of the degree of standardization of the stimulus on the variability of the data were inconclusive. We thus conclude that the use of recorded auditory stimuli to promote positive affective states during human-animal interactions in experimental settings is possible, but not necessarily preferable. (shrink)

Researchers have theoretically proposed that humans decode other individuals' emotions or elementary cognitive appraisals from particular sets of facial action units (AUs). However, only a few empirical studies have systematically tested the relationships between the decoding of emotions/appraisals and sets of AUs, and the results are mixed. Furthermore, the previous studies relied on facial expressions of actors and no study used spontaneous and dynamic facial expressions in naturalistic settings. We investigated this issue using video recordings of facial expressions filmed unobtrusively (...) in a real-life emotional situation, specifically loss of luggage at an airport. The AUs observed in the videos were annotated using the Facial Action Coding System. Male participants ( n = 98) were asked to decode emotions (e.g., anger) and appraisals (e.g., suddenness) from facial expressions. We explored the relationships between the emotion/appraisal decoding and AUs using stepwise multiple regression analyses. The results revealed that all the rated emotions and appraisals were associated with sets of AUs. The profiles of regression equations showed AUs both consistent and inconsistent with those in theoretical proposals. The results suggest that (1) the decoding of emotions and appraisals in facial expressions is implemented by the perception of set of AUs, and (2) the profiles of such AU sets could be different from previous theories. (shrink)

When a fragmented line-drawing of an object moves relative to a background of randomly oriented lines, the previously hidden object can be segregated from the background and consequently enters awareness. In this shape-from-motion paradigm, the percept of the object briefly persists after the motion stops, demonstrating the maintenance of a bound percept in awareness. This study investigated how the manipulation of object features that are crucial to recognition influences both the binding process and the maintenance of objects in awareness. Overall, (...) we found that objects that took longer to recognize were nonetheless maintained in awareness for longer. We argue that this effect is mediated by additional elaborative processing that is required to bind these less recognizable forms, which generates stronger and more robust representations. These representations are then more easily maintained in awareness, suggesting an important role of elaborative mechanisms for conscious representations. (shrink)

Moral case deliberation as a form of clinical ethics support is usually implemented in health care institutions and educational programs. While there is no previous research on the use of clinical ethics...

Human–robot interactions are often affected by error situations that are caused by either the robot or the human. Therefore, robots would profit from the ability to recognize when error situations occur. We investigated the verbal and non-verbal social signals that humans show when error situations occur in human–robot interaction experiments. For that, we analyzed 201 videos of five human–robot interaction user studies with varying tasks from four independent projects. The analysis shows that there are two types of error situations: social (...) norm violations and technical failures. Social norm violations are situations in which the robot does not adhere to the underlying social script of the interaction. Technical failures are caused by technical shortcomings of the robot. The results of the video analysis show that the study participants use many head movements and very few gestures, but they often smile, when in an error situation with the robot. The results suggest that participants do not see the robot as a social interaction partner with comparable communication skills. Our findings have implications for builders and evaluators of human–robot interaction systems. The builders need to consider including modules for recognition and classification of head movements to the robot input channels. The evaluators need to make sure that the presence of an experimenter does not skew the results of their user studies. (shrink)

Orientation towards application, transdisciplinarity and social distribution are prominent ideas when policy prescribes how to conduct research on complex, real-world issues. Issues dealt with in a...

This edited volume traces cultural appearances of disgust and investigates the varied forms and functions disgust takes and is given in both established and vernacular cultural practises. Contributors focus on the socio-cultural creation, consumption, reception and experiencing of disgust, a visceral emotion whose cultural situatedness and circulation has historically been overlooked in academic scholarship. Chapters challenge and supplement the biological understanding of disgust as a danger reaction and as a base emotion evoked by the lower senses, touch, taste and smell, (...) through a wealth of original case studies in which disgust is analyzed in its aesthetic qualities, and in its cultural and artistic appearances and uses, featuring visual and aural media. Because it is interdisciplinary, the book will be of interest to scholars in a wide range of fields, including visual studies, philosophy, aesthetics, sociology, history, literature, and musicology. (shrink)