Various due process provisions designed for use by civil servants in administrative decision-making may become redundant when automated decision-making is taken into use in public administration. Problems with mechanisms of good government, responsibility and liability for automated decisions and the rule of law require attention of the law-maker in adapting legal provisions to this new form of decision-making. Although the general data protection regulation of the European Union is important in acknowledging automated decision-making, most of the (...) legal safeguards within administrative due process have to be provided for by the national law-maker. It is suggested that all countries have a need to review their rules of administrative due process with a view to bringing them up to date regarding the requirements of automated decision-making. In whichever way the legislation is framed, the key issues are that persons who develop the algorithm and the code as well as persons who run or deal with the software within public authorities are aware of the preventive safeguards of legality in the context of automated decision-making, not only of the reactive safeguards constituted by the complaint procedures, and that legal mechanisms exist under which these persons can be held accountable and liable for decisions produced by automated decision-making. It is also argued that only rule-based systems of automatized decision-making are compatible with the rule of law and that there is a general interest in preventing a development into a rule of algorithm. (shrink)

Side effects are a concern in medical decision making and a robust area of biomedical research. However, there is relatively little philosophical investigation into side effects as such, especially given that side effects are appealed to for various applications in philosophy of medicine. In addition, health authorities like the FDA, CDC, and WHO have contrary definitions of ‘side effect.’ Moreover, these definitions have clear counterexamples. This dissertation aims to provide a complete account of what side effects are. I posit (...) that an account of side effects ought to draw clean conceptual lines between side effects and related treatment outcomes. I contend that an account of side effects must address two components: the reasons behind an intervention that produced the side effect, and the causal powers of the intervention that brought about that effect. With this account in mind, I address contemporary philosophical models that distinguish placebo effects from side effects. These arguments, respectively in chapters 2 and 3, yield a more complete, less problematic account of side effects than previous accounts. The dissertation then turns to the process of discovering side effects, specifically in the post-market context. Given the paucity of external validity in pre-market drug trials, chapter 4 argues that post-market ‘phase IV’ trials blur the received distinction of ‘confirmatory’ versus ‘exploratory’ experimentation in philosophy of science. The other component of post-market drug research is spontaneous reporting, or the voluntary reporting of a suspected side effect to a regulatory body. Chapter 5 uses the framework of risks and values in science to examine why clinicians underreport, which hinders our ability to prevent drug-related harms. Chapter 6 looks at how patients could mitigate underreporting and develops a social-epistemic, pragmatic, and ethical framework which can evaluate proposals to engage patients to spontaneously report their suspected side effects. In short, this dissertation aims to firstly address the conceptual problems in how we define ‘side effect’ and relate it to other treatment outcomes, and secondly it addresses issues that hinder the scientific investigation of side effects. (shrink)

Recent professional guidelines published by the General Medical Council instruct physicians in the UK to be honest and open in any financial agreements they have with their patients and third parties. These guidelines are in addition to a European policy addressing disclosure of physician financial interests in the industry. Similarly, In the US, a national open payments program as well as Federal regulations under the Affordable Care Act re-address the issue of disclosure of physician financial interests in America. These new (...) professional and legal changes make us rethink the fiduciary duties of providers working under new organizational and financial schemes, specifically their clinical fidelity and their moral and professional obligations to act in the best interests of patients. The article describes the legal changes providing the background for such proposals and offers a prima facie ethical analysis of these evolving issues. It is argued that although disclosure of conflicting interest may increase trust it may not necessarily be beneficial to patients nor accord with their expectations and needs. Due to the extra burden associated with disclosure as well as its implications on the medical profession and the therapeutic relationship, it should be held that transparency of physician financial interest should not result in mandatory disclosure of such interest by physicians. It could lead, as some initiatives in Europe and the US already demonstrate, to voluntary or mandatory disclosure schemes carried out by the industry itself. Such schemes should be in addition to medical education and the address of the more general phenomenon of physician conflict of interest in ethical codes and ethical training of the parties involved. (shrink)

Approximately one in 10 children in foster care are medically complex and require intensive medical supervision, frequent hospitalization, and difficult medical decision making. Some of these children are in foster care because their parents cannot care for their medical needs; other parents are responsible for their child’s medical needs due to abuse or neglect. In either case, there can be uncertainty about the role that a child’s biological parents should play in making serious medical decisions. Here we highlight (...) some of the ethical challenges inherent in making these decisions for children in foster care, as seen through the lenses of a child welfare provider, an inpatient care physician, and a primary care pediatrician. (shrink)

Artificial intelligence (AI) technologies are increasingly creeping into the work sphere, thereby gradually questioning and/or disturbing the long-established moral concepts and norms communities have been using to define what makes work good. Each community, and Muslims make no exception in this regard, has to revisit their moral world to provide well-thought frameworks that can engage with the challenging ethical questions raised by the new phenomenon of AI-mediated work. For a systematic analysis of the broad topic of AI-mediated work ethics from (...) an Islamic perspective, this article focuses on presenting an accessible overview of the “moral world” of work in the Islamic tradition. Three main components of this moral world were selected due to their relevance to the AI context, namely (1) Work is inherently good for humans, (2) Practising a religiously permitted profession and (c) Maintaining good relations with involved stakeholders. Each of these three components is addressed in a distinct section, followed by a sub-section highlighting the relevance of the respective component to the particular context of AI-mediated work. The article argues that there are no unsurmountable barriers in the Islamic tradition against the adoption of AI technologies in work sphere. However, important precautions should be considered to ensure that embracing AI will not be at the cost of work-related moral values. The article also highlights how important lessons can be learnt from the positive historical experience of automata that thrived in the Islamic civilization. (shrink)

Operational psychology is an emerging subdiscipline that has enhanced the U.S. military's combat capabilities during the Global War on Terrorism. What makes this subdiscipline unique is its use of psychological principles and skills to improve a commander's decision making as it pertains to conducting combat (or related operations). Due to psychology's expanding role in combat support, psychologists are being confronted with challenges that require the application of their professional ethics in areas in which little if any guidance has been (...) provided. Operational psychologists are at the forefront of this expansion. Accordingly, they need a decision model to assist them in this complex dynamic environment. To this end, this article reviews various decision models and ethical frameworks, selects the most appropriate, and then applies it to the challenges faced by operational psychologists. A naturalistic decision model that integrates rational and intuitive elements is recommended. (shrink)

In this paper I propose an account of representation for scientific models based on Kendall Walton’s ‘make-believe’ theory of representation in art. I first set out the problem of scientific representation and respond to a recent argument due to Craig Callender and Jonathan Cohen, which aims to show that the problem may be easily dismissed. I then introduce my account of models as props in games of make-believe and show how it offers a solution to the problem. Finally, I demonstrate (...) an important advantage my account has over other theories of scientific representation. All existing theories analyse scientific representation in terms of relations, such as similarity or denotation. By contrast, my account does not take representation in modelling to be essentially relational. For this reason, it can accommodate a group of models often ignored in discussions of scientific representation, namely models which are representational but which represent no actual object. (shrink)

According to Richard Jeffrey’s value-free ideal, scientists should avoid making value judgments about inductive risks by offering explicit representations of scientific uncertainty to decision-makers, who can use these to make decisions according to their own values. Some philosophers have responded by arguing that higher-order inductive risks arise in the process of producing representations of uncertainty. This chapter explores this line of argument and its limits, arguing that the Jeffreyan value-free ideal is achievable in contexts where methodological decisions introduce minimal (...) higher-order uncertainty and where communications of uncertainty are unlikely to be manipulated or misunderstood by scientists or decision-makers. This chapter illustrates the limits of the Jeffreyan ideal with reference to climate science and argues that the context of climate science is not conducive to the Jeffreyan ideal, so the argument that climate modeling is value-laden due to higher-order inductive risks withstands recent criticisms. (shrink)

Person‐specific evidence was developed as a grounded theory by analyzing 20 selected case descriptions from interventions using the guided self‐determination method with people with various long‐term health conditions. It explains the mechanisms of mobilizing relational capacity by including person‐specific evidence in shared decision‐making. Person‐specific self‐insight was the first step, achieved as individuals completed reflection sheets enabling them to clarify their personal values and identify actions or omissions related to self‐management challenges. This step paved the way for sharing these insights (...) and challenges in a relationship with a supportive health professional, who could then rely on person‐specific evidence instead of assumptions or a narrow disease perspective for shared decision‐making. Trust in the evidence encouraged the supportive health professional to transfer it to the interdisciplinary team. Person‐specific evidence then enhanced the ability of team members to apply general evidence in a meaningful way. The increased openness achieved by individuals through these steps enabled them to eventually share their new self‐insights in daily life with other people, decreasing loneliness they experienced in self‐management. Relational capacity, the core of the theory, is mobilized in both people with long‐term health conditions and healthcare professionals. Further research on person‐specific evidence and relational capacity in healthcare is recommended. (shrink)

This paper examines women’s experiences with decision-making about non-invasive prenatal testing (NIPT). Such tests offer knowledge about chromosomal disorders early in pregnancy, without the risk of miscarriage associated with invasive procedures such as amniocentesis. Based on qualitative interviews with women in Germany who used, or declined, NIPT, we show how some women, who would not consider amniocentesis due to the risk of miscarriage, welcome the knowledge provided by, and the additional agency resulting from, NIPT. For others, declining the offer (...) to “know more” becomes increasingly difficult to articulate. The absence of risk strips women of a “good reason” to justify their decision not to test, thus implicitly challenging their “right not to know.” Moreover, NIPT heightens moral dilemmas within relationships with partners, existing children, and sometimes other close relatives. While clinically “non-invasive,” we argue that NIPT changes decision-making in an ethically and socially highly significant way. (shrink)

Police officers often encounter potentially dangerous situations in which they strongly rely on their ability to identify threats quickly and react accordingly. Previous studies have shown that practical experience and targeted training significantly improve threat detection time and decision-making performance in law enforcement situations. We applied 90-min traditional firearms training as a control condition and a specifically developed intervention training to police cadets. The intervention training contained theoretical and practical training on tactical gaze control, situational awareness, and visual attention, (...) while the control training focused on precision and speed. In a pre- and posttest, we measured decision-making performance as well as response preparation and execution to evaluate the training. Concerning cognitive performance training, the number of correct decisions increased from pre- to posttest. In shoot scenarios, correct decisions improved significantly more in the intervention group than in the control group. In don’t-shoot scenarios, there were no considerable differences. Concerning the training of response preparation and execution in shoot scenarios, the intervention group’s response time, but not hit time, decreased significantly from pre- to posttest. The control group was significantly faster than the intervention group, with their response and hit time remaining constant across pre- and posttest. Concerning the training of tactical action control, the intervention group performed significantly better than the control group. Moreover, the intervention group improved the tactical handling of muzzle position significantly. The results indicate that a single 90-min session of targeted gaze control and visual attention training improves decision-making performance, response time, and tactical handling of muzzle position in shoot scenarios. However, these faster response times do not necessarily translate to faster hit times – presumably due to the motor complexity of hitting an armed attacker with live ammunition. We conclude that theory-based training on tactical gaze control and visual attention has a higher impact on police officers’ decision-making performance than traditional firearms training. Therefore, we recommend law enforcement agencies include perception-based shoot/don’t-shoot exercises in training and regular tests for officers’ annual firearm requalification. (shrink)

Meaning-making plays a central role in how we deal with experiences of suffering, including those due to mental disorder. And for many, religious beliefs, experiences, and practices (hereafter, religious engagement) play a central role in informing this meaning-making. However, a crucial facet of the relationship between experiences of mental disorder and religious engagement remains underexplored—namely the potentially positive effects of mental disorder on religious engagement (e.g. experiences of bipolar disorder increasing sense of God’s presence). In what follows, I (...) will present empirical findings from two recent studies of mine which shed light on the extent to which participants experienced these positive effects, specific components of these effects, and how they fit into their understanding of their mental disorder and its relationship to their religious identity. In doing so, I will draw on and expand Tasia Scrutton’s Potentially Transformative view (2015a, 2015b, 2020) according to which mental disorders may provide opportunities for spiritual growth. My empirical results align with and help deepen an account according to which mental disorders are potentially spiritually transformative by providing further insight into such instances: specifically, which symptoms and internal and external factors are often involved, as well as which religious beliefs, experiences, and/or practices are often affected. After presenting these results and articulating their relevance for a potentially transformative view of mental disorder, I will then address some potential objections to the theoretical account as well as some limitations of the empirical work, before sketching possible promising directions for future research. (shrink)

The practice of democracy without insisting on its ethical values is bound to fail in any part of the world. This is what is currently going on in Nigeria. Are the principles of democracy congenial to these values? If they are, why do Nigerian politicians who are operating democratic style of governance not reflect these democratic values in their actions and words? This research study sets out to examine the possibility of making sense of the existing ethical connotation inherent (...) in the practice of democracy to its practitioners in Nigeria, Africa and the world at large. Does democracy as it is practiced in Nigeria induce or otherwise jettison ethical practices? The study adopts the socio-ethical method to critically examine the mutual interactive effects of the relationship between ethics and democracy. The study discovers that due to the high level of poverty in Nigeria and Africa, political leaders prefer to think, act, and work in order to satisfy their personal interest to the detriment of the interest of the public. The study concludes that at the moment, there is no mutual relationship between ethics and democracy in Nigeria. The achievement of this link is the beginning of development in Africa. (shrink)

Background Prioritization decision-making arises when nurses encounter intricate situations that demand ethically challenging judgments about care. This phenomenon has rarely been studied in nursing homes. Prioritization decision-making may lead to instances where individuals in social and healthcare may not receive all services they need. Making prioritization decisions and awareness of their consequences can increase nurses’ workload. Aim To describe prioritization decision-making regarding unfinished nursing care in nursing homes. Research design A qualitative descriptive study conducted through individual (...) theme interviews. Participants were recruited through social media. The data was analyzed using inductive content analysis. Participants and research context Nurses ( n = 23) working in nursing homes for the elderly people in Finland. Data were collected between June 2022 and February 2023. Ethical considerations Finnish legislation does not mandate an ethical review or research permits, as the participants took part as private individuals. [ask authors to make reference here to informed consent process and anonymity] Findings Nurses stated that the need for prioritization decision-making arises from challenges associated with nurses’ engagement with person-centered care, the culture of the work community, the burden due to workload and challenges associated with the leadership. Prioritization decision-making was based on the interests of residents, striving for an efficient workflow and nurse’s personal interests. Nurses did not receive support for decision-making regarding unfinished care, and protocols for prioritization had not been established in their work communities. Prioritization decision-making and unfinished care were concealed and left unspoken. Conclusion Nursing leaders should address this hidden phenomenon, making it visible through discussions with nurses and by involving them in the development of protocols. The findings can be utilized for developing new approaches to support nurses and reduce their workload and for enhancing the quality and person-centeredness of nursing care in nursing homes. (shrink)

Background: Pediatric guidelines recommend that children and adolescents participate in a developmentally appropriate way in end-of-life decision making. Shared decision making in pediatrics is unique because of the triadic relationship of patient, parents, and physician. The involvement of the patient may vary on a continuum from no involvement to being the sole decision maker. However, the effects of child participation have not been thoroughly studied. The aims of this literature review are to identify studies on end-of-life decision (...) class='Hi'>making in pediatrics, to explore patient participation, and to assess the effects of such participation. Methods: Five databases—PubMed, PsycInfo, Medline, CINAHL, and Sociological Abstract—were searched for empirical studies on end-of-life decision making in pediatrics. Selected articles fulfilling the criteria were assessed for type of decision, participants’ characteristics, reports on participation of the minor patient, and outcome. Results: Fifty-seven articles on end-of-life decision making in pediatrics were identified. The majority of papers (n = 43, 75%) investigated parents’ and clinicians’ perspectives, while only 14 articles (25%) included perspectives of children and adolescents. Twenty-two articles (39%) reported some details on various forms of children's participation (e.g., receive information, plan care details, consulted before or after a decision was made). Positive (e.g., respect for patient's preferences) and negative (e.g., conflict due to diverging opinions) effects of children's participation in end-of-life decision making were reported. Conclusions: This systematic review highlights the need for research to identify factors that contribute to a favorable participation of minors in decision-making processes, as well as strategies to solve possible conflicts. More research should take into account the dynamics in the triadic process of decision making and emphasize children and adolescents’ perspectives. A better understanding of how to meaningfully involve children and adolescents in end-of-life decision making could facilitate the practice of patient participation in pediatrics. (shrink)

During the COVID-19 pandemic, global healthcare systems faced unprecedented challenges, with a lack of resources and suboptimal patient care emerging as primary concerns. Our research, using a comprehensive 24-item electronic questionnaire, “Reflections on the Provision of Healthcare during the COVID-19 Pandemic,” delved into the experiences of 938 physicians across the Czech Republic. Over fifty per cent observed a “lower standard of care” compared to pre-pandemic levels. A division arose among physicians regarding a decision’s medical, ethical, or legal basis, with a (...) notable gender disparity: male doctors leaned towards medical perspectives, whereas females accented the ethical perspective. Decision-making concerning health care limitations required agreement among the physicians on duty, interdisciplinary teams, or shift supervisors. Physicians reported varying degrees of patient or family participation in health care decisions. Variables such as age, pre-existing health conditions, and life expectancy influenced care decisions. Surprisingly, half of the physicians faced refusals of patients’ transportation to better-equipped facilities due to resource constraints. One-third of physicians never discuss the decision about care limitation and other options with patients or their families. As a result, almost fifty per cent of the physicians rarely or never imparted information about care limitations to patients. The survey shed light on the profound ethical dilemmas hospital physicians face across different types of healthcare facilities during the pandemic. It uncovered the need for open dialogue and scholarly debate on resource allocation and strengthening the role of patients and their families in care decisions in future healthcare crises. (shrink)

The COVID-19 pandemic has highlighted the difficult task of balancing access to misinformation with respect for patient decision-making. Due to its innate antagonism, the paradigm of “physician paternalism” versus “patient autonomy” may not adequately capture the clinical relationship. The authors hypothesized that most patients would, in fact, prefer significant physician input as opposed to unopinionated information when making medical decisions. There is a lack of empirical data corroborating this in the United States. To that end, a survey was (...) distributed to 650 individuals through Amazon Mechanical Turk, of which 499 responses met pre-determined quality criteria. Most respondents believed their doctor's insight would be better than their own if injured or gravely ill. When asked to affirm preferences separately, a significantly higher proportion of respondents preferred guidance from their doctor when making medical decisions compared to being presented with unopinionated information ( p < 0.001). Encouragingly, 93.1% believed that the doctor's primary goal was their health. When asked directly to compare physician guidance to unopinionated information, 69.1% respondents stated they would prefer physician guidance. We found a consistent association between educational/economic background and affirmative responses ( p < 0.001), suggesting particular attention should be paid to patients that are disadvantaged with respect to these demographic factors. The belief in a shared goal, and a consistent preference for physician input, suggests that patients endorse a more collaborative view of the clinical dynamic than is suggested by the paternalism-autonomy paradigm. This pilot study suggests physicians should not be afraid to communicate conviction with regard to treatment decisions. (shrink)

In commerce, many moral failures are due to narrow mindsets that preclude taking into account the moral dimensions of a decision or action. In turn, sometimes these mindsets are caused by failing to question managerial decisions from a moral point of view, because of a perceived authority of management. In the 1960s, Stanley Milgram conducted controversial experiments to investigate just how far obedience to an authority figure could subvert his subjects' moral beliefs. In this thought-provoking work, the authors examine the (...) prevalence of narrow mental models and the phenomenon of obedience to an authority to analyse and understand the challenges which business professionals encounter in making ethical decisions. Obstacles to Ethical Decision-Making proposes processes - including collaborative input and critique - by which individuals may reduce or overcome these challenges. It provides decision-makers at all levels in an organisation with the means to place ethical considerations at the heart of managerial decision-making. (shrink)

The rapid evolution of scientific research has created a pressing need for efficient and versatile tools to aid researchers. While using artificial intelligence (AI) to write scientific articles is unethical and unreliable due to the potential for inaccuracy, AI can be a valuable tool for assisting with other aspects of research, such as language editing, reference formatting, and journal finding. Two of the latest AI-driven assistants that have become indispensable assets to scientists are ChatGPT and Gemini (Bard). These assistants offer (...) comprehensive support from literature review to journal suggestion, and they have the potential to revolutionize research. In the present study, a comprehensive set of queries and responses were designed to assess the capabilities of ChatGPT-3.5 and Gemini as scientific assistants. The results showed that Gemini achieved a perfect score of 100%, while ChatGPT-3.5 scored a less impressive 70%. Notably, ChatGP-3.5 fell short in specific areas that includes providing assistance with scientific paper explanations, exploring bibliographic databases, and formatting references. The qualitative assessment of responses also suggests that both the AI chatbots can be valuable tools for researchers, however, Gemini seems to be more appealing and accurate through the whole procedure of scientific writing. This work shall open new research dimensions in identifying adequate scientific utilization of the evolving AI tools and technologies, as embracing these advancements will be essential for staying at the forefront of scientific research. (shrink)

Shared Decision Making (‘SDM’) is one of the most significant developments in Western health care practices in recent years. Whereas traditional models of care operate on the basis of the physician as the primary medical decision maker, SDM requires patients to be supported to consider options in order to achieve informed preferences by mutually sharing the best available evidence. According to its proponents, SDM is the right way to interpret the clinician-patient relationship because it fulfils the ethical imperative of (...) respecting patient autonomy. However, there is no consensus about how decisions in SDM contexts relate to the principle of respect for autonomy. In response, I demonstrate that in order to make decisions about what treatment they will or will not receive, patients will be required to meet different conditions depending on the approach proponents of SDM take to understanding personal autonomy. Due to the fact that different conceptions of autonomy yield different obligations, I argue that if physicians and patients satisfied all the conditions described in standard accounts of SDM, then SDM would undermine patient autonomy. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:What Makes the Common Good Common?Key Points from Charles De Koninck1Aquinas Guilbeau, O.P.In even the most capable philosophical hands, the common good remains a slippery concept. Its essence eludes the grasp of those who reach for it. This is due in part to the concept's complexity. "Common good" is composed of two rich, philosophically pregnant notions: goodness and commonness. Reflection on these two notions is ancient, of course. How (...) a thing is good has preoccupied philosophers since the dawn of time. How a thing may be common has exercised philosophers less throughout history, but even the ancients recognized that the question of a thing's commonness remains as intricate as the question of a thing's goodness. Despite their long philosophical history, however, the notions of goodness and commonness evade quick and easy description. Because they represent elemental characteristics of being itself, they share in being's fundamental mystery. As a result, millennia of reflection have not exhausted these notions' meanings. Like being, goodness and commonness require careful study by each generation, so that its intellectuals and teachers might clarify these notions' remaining secrets. Thus does each generation contribute to the perennial philosophy.When we modern and post-modern thinkers try to describe the common good, and thereby grapple with its notions of goodness and commonness, we find one of these two notions more elusive than the other. Which of the two might surprise us. It is not the common good's goodness. [End Page 739] Despite the philosophical confusions of our age, we more or less still agree publicly as to what constitutes a good, and as a result what constitutes an evil. We deem health a good, for example, while we deem disease an evil. We embrace one as perfective; we repulse the other as destructive. To my knowledge, no one has yet extolled COVID-19 as a good. So, we moderns and post-moderns have not completely lost hold of reality. We still share a sense of goodness, even if our generation mislabels some evils as goods.When it comes to describing the common good, therefore, it is not the common good's goodness that eludes us. Rather, it is its commonness that we have difficulty grasping. What does it mean for a good to be common? How is a common good common? Are all common goods common in the same way? How is the example of health common? Is health a common good properly speaking, or does it only appear to be common? How do we know the difference? Is there a difference? Unfortunately, few of us can answer these questions well. The reasons may not all be our fault, but we should admit that, along with our secular contemporaries, we remain largely unversed in commonness. A sign of our inexperience with the concept is that we seldom ask questions about commonness. Instead, we take it for granted that we know what commonness involves. When pressed to describe it, however, we quickly discover just how uncommon understanding of commonness is.In the first half of the last century, Charles De Koninck was well aware of modernity's inexperience with commonness. He recognized that individualism and its philosophical prerequisites had so captured the popular imagination, even among Catholics, that the common quality of the common good was disappearing from view. As a result, political discourse—to say nothing of political life—had entered serious difficulty. Between the World Wars, De Koninck spoke up among Catholic philosophers to remind them of the "primacy of the common good," not simply as a practical concept but as a speculative one, in accord with its classical conception.De Koninck recalled for his contemporaries not only that but also how commonness, like goodness, is primarily something objectively real and metaphysically constituted, and only secondarily something subjectively perceived and practically useful. To revive the objective and metaphysical notions of goodness and commonness among Catholic intellectuals—many of whom had traded these for easier subjective and practical notions2—De [End Page 740] Koninck composed his famous essay The Primacy of the Common Good, Against the Personalists.3 In it, De Koninck spends eighty pages reviewing the objective... (shrink)

Meaning-making plays a central role in how we deal with experiences of suffering, including those due to mental disorder. And for many, religious beliefs, experiences, and practices (hereafter, religious engagement) play a central role in informing this meaning-making. However, a crucial facet of the relationship between experiences of mental disorder and religious engagement remains underexplored—namely the potentially positive effects of mental disorder on religious engagement (e.g. experiences of bipolar disorder increasing sense of God’s presence). In what follows, I (...) will present empirical findings from two recent studies of mine which shed light on the extent to which participants experienced these positive effects, specific components of these effects, and how they fit into their understanding of their mental disorder and its relationship to their religious identity. In doing so, I will draw on and expand Tasia Scrutton’s Potentially Transformative view (2015a, 2015b, 2020) according to which mental disorders may provide opportunities for spiritual growth. My empirical results align with and help deepen an account according to which mental disorders are potentially spiritually transformative by providing further insight into such instances: specifically, which symptoms and internal and external factors are often involved, as well as which religious beliefs, experiences, and/or practices are often affected. After presenting these results and articulating their relevance for a potentially transformative view of mental disorder, I will then address some potential objections to the theoretical account as well as some limitations of the empirical work, before sketching possible promising directions for future research. (shrink)

: Carson Strong criticizes the application of my moral theory to bioethics cases. Some of his criticisms are due to my failure to make explicit that both the irrationality or rationality of a decision and the irrationality or rationality of the ranking of evils are part of morally relevant feature 3. Other criticisms are the result of his not using the two-step procedure in a sufficiently rigorous way. His claim that I come up with a wrong answer depends upon his (...) incorrectly regarding a weakly justified violation as one that all impartial rational persons would agree was permitted, rather than as one about which rational persons disagree. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Philosophy 42.1 (2004) 107-108 [Access article in PDF] H. H. M. van Lieshout. The Making of Pierre Bayle's Dictionaire Historique et Critique: With a CD-ROM containing the Dictionaire's library and references between articles. Translated by Lynne Richards. Amsterdam and Utrecht: APA-Holland University Press, 2001. Pp. xxiv + 339. Cloth, + 58,00. Bayle's Dictionaire Historique et Critique was published in 1697 in Rotterdam with (...) a second edition appearing in 1702. In this journal there should be no need to point out that Bayle (1647-1706) was by vocation a professor of philosophy. His courses were divided into logic, ethics, physics, and metaphysics and their emphasis was upon science and the methods appropriate to its pursuit. That is to say that Bayle's students received a grounding in the post-Cartesian philosophy syllabus that had spread throughout continental Europe in the second half of the seventeenth century. Indeed, that Bayle was no dilettante was evidenced by the fact that before embarking on the Dictionaire in 1692, he had published various monographs on natural philosophy and works of public criticism in the skeptical/rationalist tradition. The French thinker, furthermore, despite his success as an encyclopaedist, returned increasingly in the years from 1697-1706 to his first calling as a critical philosopher. [End Page 107]Nevertheless from his student days Bayle loved books for their own sake, a passion which in due course came to support his first literary enterprise, the journal of books Nouvelles de la République des Lettres (1684). As author of the Dictionaire, he attracted attention from scholars in many disciplines. This study addresses therefore the general scholar rather than the historian of philosophy, for the Dictionaire did indeed become an indispensable work of reference for lexicographers, as well as for the encyclopaedists, the philosophes, the historians, the economists, the physiocrats, the satirists, the poets, and the reformers throughout the eighteenth century and on both sides of the Atlantic. Bound within four in-folio volumes, its second edition consisted of some seventeen hundred bio-bibliographical articles rigorously annotated and devoted to the ideas of authors in print, profane and sacred.Yet how could one author, it has often been asked, have produced in a mere five years so monumental a work? The Dutch scholar Leny Van Lieshout, already author of works of distinction about Bayle, has sought to answer this question and has done so with a rigor that equals that of Bayle himself. To assist her analysis she has compiled a bibliography of all the sources cited in the text of the Dictionaire itself. She has then matched this source, which she describes as a "library for learned Europe" (177), with Bayle's prodigious and lifelong correspondence about books with an ever-expanding network of friends and associates.With such tools at her elbow, Dr. Van Lieshout has been able to throw new light on many questions about the making of the Dictionaire. For example, how far did Bayle consider his method to be a model for the sort of reference book appropriate to a post-theological culture which today we call a plural age? His medium was indeed part of the message insofar as he sought to separate fact from comment, to cite relevant evidence, and to invoke many classical and heterodox sources whether or not they might offend an apologist for Christian doctrine. And how far did Bayle's own life really lie "only in his writings" (150) as Voltaire suggested, implying that Bayle could not have achieved so much had he not been a dry Huguenot recluse who knew little or nothing of the real world? The two questions are shown to be connected. In respect of the first, Dr. Van Lieshout observes that through the very structure of the Dictionaire Bayle seeks to assert that the political authority of the Church, following the breakdown of former Catholic Christendom, had ceased to be appropriate to the pursuit of scientific... (shrink)

In this topical section, we highlight the next step of research on modeling aiming to contribute to the emerging literature that radically refrains from approaching modeling as a scientific endeavor. Modeling surpasses “doing science” because it is frequently incorporated into decision-making processes in politics and management, i.e., areas which are not solely epistemically oriented. We do not refer to the production of models in academia for abstract or imaginary applications in practical fields, but instead highlight the real entwinement of (...) science and policy and the real erosion of their boundaries. Models in decision making – due to their strong entwinement with policy and management – are utilized differently than models in science; they are employed for different purposes and with different constraints. We claim that “being a part of decision-making” implies that models are elements of a very particular situation, in which knowledge about the present and the future is limited but dependence of decisions on the future is distinct. Emphasis on the future indicates that decisions are made about actions that have severe and lasting consequences. In these specific situations, models enable not only the acquisition of knowledge (the primary goal of science) but also enable deciding upon actions that change the course of events. As a result, there are specific ways to construct effective models and justify their results. Although some studies have explored this topic, our understanding of how models contribute to decision making outside of science remains fragmentary. This topical section aims to fill this gap in research and formulate an agenda for additional and more systematic investigations in the field. (shrink)

Can nature be reconstituted, recreated or rehabilitated? And would the goal of doing so be a desirable one? There again, is wild nature intrinsically valuable, or are parks, gardens and farms sometimes preferable or of greater value? This cluster of questions arises from recent debates about preservation, restoration, wilderness and sustainable development. In discussing them I hope to throw some light on both the concept and the value of nature, and in due course on the attitudes which people should have (...) towards it, the policies which should guide their practice, and thus on the proper role of humanity with regard to the natural world. (shrink)

Given the nature of the discipline, it might be assumed that clinical psychology is an ethical profession, within which effective ethical decision-making is integral. How then, does this ethical decision-making occur? This paper describes a systematic review of empirical research addressing this question. The paucity of evidence related to this question meant that the scope was broadened to include other professions who deliver talking therapies. This review could support reflective practice about what may be taken into account when (...) making ethical decisions and highlight areas for future research. Using academic search databases, original research articles were identified from peer-reviewed journals. Articles using qualitative ( n = 3), quantitative ( n = 8) and mixed methods ( n = 2) were included. Two theoretical models of aspects of ethical decision-making were identified. Areas of agreement and debate are described in relation to factors linked to the professional, which impacted ethical decision-making. Factors relating to ethical dilemmas, which impacted ethical decision-making, are discussed. Articles were appraised by two independent raters, using quality assessment criteria, which suggested areas of methodological strengths and weaknesses. Comparison and synthesis of results revealed that the research did not generally pertain to current clinical practice of talking therapies or the particular socio-political context of the UK healthcare system. There was limited research into ethical decision-making amongst specific professions, including clinical psychology. Generalisability was limited due to methodological issues, indicating avenues for future research. (shrink)

In recent years there has been an explosion of interest in Artificial Intelligence (AI) both in health care and academic philosophy. This has been due mainly to the rise of effective machine learning and deep learning algorithms, together with increases in data collection and processing power, which have made rapid progress in many areas. However, use of this technology has brought with it philosophical issues and practical problems, in particular, epistemic and ethical. In this paper the authors, with backgrounds in (...) philosophy, maternity care practice and clinical research, draw upon and extend a recent framework for shared decision-making (SDM) that identified a duty of care to the client's knowledge as a necessary condition for SDM. This duty entails the responsibility to acknowledge and overcome epistemic defeaters. This framework is applied to the use of AI in maternity care, in particular, the use of machine learning and deep learning technology to attempt to enhance electronic fetal monitoring (EFM). In doing so, various sub-kinds of epistemic defeater, namely, transparent, opaque, underdetermined, and inherited defeaters are taxonomized and discussed. The authors argue that, although effective current or future AI-enhanced EFM may impose an epistemic obligation on the part of clinicians to rely on such systems' predictions or diagnoses as input to SDM, such obligations may be overridden by inherited defeaters, caused by a form of algorithmic bias. The existence of inherited defeaters implies that the duty of care to the client's knowledge extends to any situation in which a clinician (or anyone else) is involved in producing training data for a system that will be used in SDM. Any future AI must be capable of assessing women individually, taking into account a wide range of factors including women's preferences, to provide a holistic range of evidence for clinical decision-making. (shrink)

Virtue has been rediscovered in the United States as a subject of public debate and of philosophical inquiry. Politicians from both parties, leading intellectuals, and concerned citizens from diverse backgrounds are addressing questions about the content of our character. William Bennett's moral guide for children, A Book of Virtues, was a national bestseller. Yet many continue to associate virtue with a prudish, Victorian morality or with crude attempts by government to legislate morals. Peter Berkowitz clarifies the fundamental issues, arguing that (...) a certain ambivalence toward virtue reflects the liberal spirit at its best. Drawing on recent scholarship as well as classical political philosophy, he makes his case with penetrating analyses of four central figures in the making of modern liberalism: Hobbes, Locke, Kant, and Mill.These thinkers are usually understood to have neglected or disparaged virtue. Yet Berkowitz shows that they all believed that government resting on the fundamental premise of liberalism--the natural freedom and equality of all human beings--could not work unless citizens and officeholders possess particular qualities of mind and character. These virtues, which include reflective judgment, sympathetic imagination, self-restraint, the ability to cooperate, and toleration do not arise spontaneously but must be cultivated. Berkowitz explores the various strategies the thinkers employ as they seek to give virtue its due while respecting individual liberty. Liberals, he argues, must combine energy and forbearance, finding public and private ways to support such nongovernmental institutions as the family and voluntary associations. For these institutions, the liberal tradition powerfully suggests, play an indispensable role not only in forming the virtues on which liberal democracy depends but in overcoming the vices that it tends to engender.Clearly written and vigorously argued, this is a provocative work of political theory that speaks directly to complex issues at the heart of contemporary philosophy and public discussion.New Forum Books makes available to general readers outstanding, original, interdisciplinary scholarship with a special focus on the juncture of culture, law, and politics. New Forum Books is guided by the conviction that law and politics not only reflect culture, but help to shape it. Authors include leading political scientists, sociologists, legal scholars, philosophers, theologians, historians, and economists writing for nonspecialist readers and scholars across a range of fields. Looking at questions such as political equality, the concept of rights, the problem of virtue in liberal politics, crime and punishment, population, poverty, economic development, and the international legal and political order, New Forum Books seeks to explain--not explain away--the difficult issues we face today. (shrink)

Recalcitrant disputes among health care providers and patients or their families may signal deep cultural differences about what interventions are needed or about clinicians’s professional duties. These issues arose in relation to a mother’s request for hymenoplasty or revirgination for her minor daughter to enable an overseas, forced marriage and protect her from an honor killing. The American College of Obstetrics and Gynecology committee recommends against members performing a hymenoplasty or other female genital cosmetic surgeries due to a lack of (...) data concerning their safety and efficacy. A key issue in such cases is how to determine what is in the minor’s best interest and the scope of health care moral or professional’s duties. The Best Interests Standard can serve as a powerful moral tool for resolving cross-cultural disputes and identifying needed policy. (shrink)

How shall we decide for others who cannot decide for themselves? And who—or what, in the case of artificial intelligence — should make the decision? The present issue of the journal tackles several interrelated topics, many of them having to do with surrogate decision making. For example, the feature article by Jardas et al 1 explores the potential use of artificial intelligence to predict incapacitated patients’ likely treatment preferences based on their sociodemographic characteristics, raising questions about the means by (...) which we come to decide for others. And a clinical ethics round table led by Wilkinson and Pillay2 examines the case of a premature baby on life support whose primary surrogate is herself incapacitated. Together, these examples force us to think more deeply about the meaning and significance of taken-for-granted concepts: respect for autonomy, substituted judgement, best interests. We’ll consider the baby first and then turn to AI. “Baby T” is a critically ill newborn delivered prematurely by emergency caesarean section. The mother had entered into a surrogacy arrangement with a same-sex male couple, the intended parents, who were to take over the baby’s care after birth—just as soon as a formal parental order could be obtained through the court. Until then, the birth mother, who had used her own eggs to conceive Baby T along with sperm from an unidentified donor, would have legal and ethical responsibility to decide about the baby’s care. Unfortunately, she too was in critical condition, having fallen unconscious prior to delivery due to a sudden brain haemorrhage. She remained unconscious, and thus incapacitated, during a crucial period in which time-sensitive decisions about Baby T’s care needed to be made, including whether to continue life support. Given the mother’s incapacity, who should …. (shrink)

Many artificial intelligence (AI) systems currently used for decision-making are opaque, i.e., the internal factors that determine their decisions are not fully known to people due to the systems’ computational complexity. In response to this problem, several researchers have argued that human decision-making is equally opaque and since simplifying, reason-giving explanations (rather than exhaustive causal accounts) of a decision are typically viewed as sufficient in the human case, the same should hold for algorithmic decision-making. Here, I contend (...) that this argument overlooks that human decision-making is sometimes significantly more transparent and trustworthy than algorithmic decision-making. This is because when people explain their decisions by giving reasons for them, this frequently prompts those giving the reasons to govern or regulate themselves so as to think and act in ways that confirm their reason reports. AI explanation systems lack this self-regulative feature. Overlooking it when comparing algorithmic and human decision-making can result in underestimations of the transparency of human decision-making and in the development of explainable AI that may mislead people by activating generally warranted beliefs about the regulative dimension of reason-giving. (shrink)

Because of its practical advantages, machine learning (ML) is increasingly used for decision-making in numerous sectors. This paper demonstrates that the integral characteristics of ML, such as semi-autonomy, complexity, and non-deterministic modeling have important ethical implications. In particular, these characteristics lead to a lack of insight and lack of comprehensibility, and ultimately to the loss of human control over decision-making. Errors, which are bound to occur in any decision-making process, may lead to great harm and human rights (...) violations. It is important to have a principled way of assigning responsibility for such errors. The integral characteristics of ML, however, pose serious difficulties in defining responsibility and regulating ML decision-making. First, we elaborate on these characteristics and their epistemic and ethical implications. We then analyze possible general strategies for resolving the assignment of moral responsibility and show that, due to the specific way in which ML functions, each potential solution is problematic, whether we assign responsibility to humans, machines, or using hybrid models. Then, we shift focus on an alternative approach that bypasses moral responsibility and attempts to define legal liability independently through solutions such as informed consent and the no-fault compensation system. Both of these solutions prove unsatisfactory because they leave too much room for potential abuses of ML decision-making. We conclude that both ethical and legal solutions are fraught with serious difficulties. These difficulties prompt us to re-weigh the costs and benefits of using ML for high-stake decisions. (shrink)

Marketers use autobiographical advertising as a means to create nostalgia for their products. This research explores whether such referencing can cause people to believe that they had experiences as children that are mentioned in the ads. In Experiment 1, participants viewed an ad for Disney that suggested that they shook hands with Mickey Mouse as a child. Relative to controls, the ad increased their confidence that they personally had shaken hands with Mickey as a child at a Disney resort. The (...) increased confidence could be due to a revival of a true memory or the creation of a new, false one. In Experiment 2, participants viewed an ad for Disney that suggested that they shook hands with an impossible character (e.g., Bugs Bunny). Again, relative to controls, the ad increased confidence that they personally had shaken hands with the impossible character as a child at a Disney resort. The increased confidence is consistent with the notion that autobiographical referencing can lead to the creation of false or distorted memory. ᭧ 2002 John Wiley & Sons, Inc. (shrink)

Competitive athletes act within cultures of risk in sports and often decide to return to sport despite having acute health problems. The outcomes of such risky return-to-play decisions can not only negatively affect their future health, but also limit their sports performance or even upset their career paths. Following risk-management-decision theory with its focus on active risk defusing, we developed a model for understanding the process of return-to-play decision making from an athlete’s perspective. Based on the method of active (...) information search, a quasi-naturalistic return-to-play decision scenario was created in order to assess amateur team sport athletes’ decision making strategies. The main goals were to identify different information acquisition patterns and to analyze the influence of social pressure to play hurt on decision making. A total of 72 competitive team sport athletes (36 females, 36 males, m= 25.7 years of age, 3rd to 6th league level) out of three disciplines (volleyball, basketball, and handball) participated in the experimental study. Facing the same medical scenario (a partial tear of the supraspinatus tendon), athletes show different approaches to return-to-play decision making. The main focus is on potential sporting consequences of withdrawal from competition due to injury, while only few players favoring well-informed decisions based on thorough risk analysis. The athletes who chose the medically risky alternative to play hurt mostly employed strategies of active risk defusing, which got activated when severe sporting consequences were perceived. Those who chose to withdraw from competition primarily referred to maximin heuristic, particularly when social pressure to play was reduced. The findings can be used to improve rehabilitation. (shrink)

It has been argued that environmental decision-making can be improved be introducing citizen panels. The authors argue that citizen panels and other models of citizen participation should only be used as a consulting forum in exceptional cases at the local level, not as a real decision-making procedure. But many problems in the field of environmental policy need nonlocal, at least regional or national, regulation due to the fact that they are of national impor-tance. The authors argue that there (...) are good reasons not to institutionalise national citizen panels. They advocate the view that more reasonable and more competent solutions can be found by introducing forms of direct democracy. (shrink)

"Science is rooted in conversations," wrote Werner Heisenberg, one of the twentieth century's great physicists. In Quantum Dialogue, Mara Beller shows that science is rooted not just in conversation but in disagreement, doubt, and uncertainty. She argues that it is precisely this culture of dialogue and controversy within the scientific community that fuels creativity. Beller draws her argument from her radical new reading of the history of the quantum revolution, especially the development of the Copenhagen interpretation. One of several competing (...) approaches, this version succeeded largely due to the rhetorical skills of Niels Bohr and his colleagues. Using extensive archival research, Beller shows how Bohr and others marketed their views, misrepresenting and dismissing their opponents as "unreasonable" and championing their own not always coherent or well-supported position as "inevitable." Quantum Dialogue, winner of the 1999 Morris D. Forkosch Prize of the Journal of the History of Ideas, will fascinate everyone interested in how stories of "scientific revolutions" are constructed and "scientific consensus" achieved. "[A]n intellectually stimulating piece of work, energised by a distinct point of view."—Dipankar Home, Times Higher Education Supplement "[R]emarkable and original. . . . [Beller's] arguments are thoroughly supported and her conclusions are meticulously argued. . . . This is an important book that all who are interested in the emergence of quantum mechanics will want to read."—William Evenson, History of Physics Newsletter. (shrink)

Reliability theories of epistemic justification face three main objections: the generality problem, the demon-world (or brain-in-a-vat) counterexample, and the clairvoyant-powers counterexample. In Perception and Basic Beliefs(Oxford 2009), Jack Lyons defends reliabilism at length against the clairvoyant powers case. He argues that the problem arises due to a laxity about the category of basic beliefs, and the difference between inferential and non-inferential justification. Lyons argues reliabilists must pay more attention to architecture. I argue this isn’t necessarily so. What really matters for (...) understanding and solving the case involves paying closer attention to the origins of our belief forming capacities, both inferential and non-inferential. Reliabilists should make origins matter more. (shrink)

By unpacking some of the dichotomies inherent in the concepts of vulnerability and disability, the article problematises some of the current legal approaches to disability in Finland. It argues that where used to single out population groups or individuals due to their embodied characteristics, the vulnerability paradigm can be seen to create binaries both among the persons with disabilities, and between the “vulnerable” persons with disabilities and the perception of a rational, self-standing and autonomous human being. To mitigate such binaries, (...) the article explores an agency-centred discourse of vulnerability, one that recognises the co-existence of agency and vulnerability and sees agency as dynamic and responsive to the societal support structures that surround all of us. One of the central arguments of the article is that generalised approaches do, however, not suffice to make agency a reality for all persons with disabilities. Given the extensive diversity of intra-group variations between persons with disabilities, individualised solutions are needed for agency to be possible for all. To overcome objectification and de-agencification – and to enhance agency – this diversity of situations, needs and contexts of lived-in realities of individuals also needs to be expressly reflected in the legal language in addressing disability. (shrink)

Whether mathematical truths are syntactical (as Rudolf Carnap claimed) or empirical (as Mill actually never claimed, though Carnap claimed that he did) might seem merely an academic topic. However, it becomes a practical concern as soon as we consider the role of questions. For if we inquire as to the truth of a mathematical statement, this question must be (in a certain respect) meaningless for Carnap, as its truth or falsity is certain in advance due to its purely syntactical (or (...) formal-semantical) nature. In contrast, for Mill such a question is as valid as any other. These differing views have their consequences for contemporary erotetic logic. (shrink)

When the first issue of this journal was published in April 1975 its inaugural editorial stated: "The aim of the Journal of Medical Ethics is to provide a forum for the reasoned discussion of moral issues arising from the provision of medical care. It will hold no brief for one particular professional, political, or religious viewpoint. The articles it publishes will identify current problems, present factual information, and clarify different moral assumptions. To fulfil these aims the Editors can call on (...) the resources of the disciplines of law, philosophy, and theology, as well as on the whole range of medical and paramedical specialties.1"This prospectus well expressed the ethos of the journal's original publisher, the Society for the Study of Medical Ethics , and was clearly reflected in the content and style of the journal's early issues. It was also reflected in the journal's authorship, which included many leading medical and other academics and professionals of the time, who demonstrated lively engagement with a variety of emerging moral issues. In due course such issues would be well recognised as the substance of ‘medical ethics’, but in 1975, as the editorial also noted, that ‘phrase’ could still ‘create misunderstandings and provoke suspicions (especially perhaps among medical …. (shrink)

During the last thirty years different methods have been proposed in order to manage and resolve ethical quandaries, specially in the clinical setting. Some of these methodologies are based on the principles of Decision-making theory. Others looked to other philosophical traditions, like Principlism, Hermeneutics, Narrativism, Casuistry, Pragmatism, etc. This paper defends the view that deliberation is the cornerstone of any adequate methodology. This is due to the fact that moral decisions must take into account not only principles and ideas, (...) but also emotions, values and beliefs. Deliberation is the process in which everyone concerned by the decision is considered a valid moral agent, obliged to give reasons for their own points of view, and to listen to the reasons of others. The goal of this process is not the reaching of a consensus but the enrichment of one's own point of view with that of the others, increasing in this way the maturity of one's own decision, in order to make it more wise or prudent. In many cases the members of a group of deliberation will differ in the final solution of the case, but the confrontation of their reasons will modify the perception of the problem of everyone. This is the profit of the process. Our moral decisions cannot be completely rational, due to the fact that they are influenced by feelings, values, beliefs, etc., but they must be reasonable, that is, wise and prudent. Deliberation is the main procedure to reach this goal. It obliges us to take others into account, respecting their different beliefs and values and prompting them to give reasons for their own points of view. This method has been traditional in Western clinical medicine all over its history, and it should be also the main procedure for clinical ethics. (shrink)

Brandom (Citation1994) made inferentialism an intensely debated idea in the philosophy of language in the last three decades. Inferentialism is a view that associates the meaning of linguistic expression with the role said expression plays in inferences. It seems rather uncontroversial that the correct theory of meaning should distinguish between linguistic correctness and factual correctness. For instance, speaker S can be wrong in saying ‘I have arthritis’ in two distinct ways: (i) S fails to apply a word correctly to make (...) a true statement due to having made a factual error, and (ii) S uses an expression incorrectly because they are wrong about its meaning. In this paper, I show that properly understood normative inferentialism can make room for such a distinction. I propose that linguistic correctness is a structural issue: linguistic mistakes stem from the improper or insufficient acquisition of an inferential role. Factual correctness, on the other hand, is a one-off issue of the correct application of inferential rules to a particular situation. I argue that, by tying the issue of correctness to the game of giving and asking for reasons, inferentialism can establish a reliable method for distinguishing between two types of correctness (and mistakes). (shrink)

Background: There currently exist no data on the factors that contribute to determining why medical ethicists choose to review for and submit articles to medical ethics journals.Objective: To establish which factors contribute to medical ethicists reviewing articles for or submitting them to medical ethics journals by consulting those who are active in this capacity.Methods: Medical ethicists were surveyed to determine their incentives and disincentives for reviewing articles for or submitting them to medical ethics journals. Survey participants were chosen based on (...) a review of the academic and research record of medical ethicists working in North America in higher education institutions.Results: The most frequent incentives to reviewing journal articles were: an opportunity to contribute to the field/profession, the good reputation of the journal, the high impact factor of the journal, and to keep up to date on current research. The most frequent disincentives to reviewing journal articles were: time constraints due to academic commitments, the poor reputation of the journal, and time constraints caused by other editorial commitments . The most important incentives to submitting journal articles were: the good reputation of the journal, the quality of scholarship previously published in the journal, the impact factor of the journal, and a fast turn-around from acceptance to publication. The most important disincentives to submitting journal articles were: the poor reputation of the journal, the poor quality of work previously published in the journal, and a slow turn-around from acceptance to publication.Conclusion: A series of factors that medical ethics journals should strive to employ to encourage reviewing and submission of articles are recommended. (shrink)

The burgeoning literature on transborder membership, largely focused on the thickening relationship between emigration states in the South and the postwar labor migrant populations and their descendants in North America or Western Europe, has not paid due attention to the long-term macroregional transformations that shape transborder national membership politics or to the bureaucratic practices of the state that undergird transborder claims-making. By comparing contentious transborder national membership politics in South Korea during the Cold War and Post-Cold War eras, this (...) article seeks to overcome these limitations. In both periods, the membership status of colonial-era ethnic Korean migrants in Japan and northeast China and their descendants was the focus of contestation. The distinctiveness of the case—involving both a sustained period of colonial rule and a period of belated and divided nation-state building interwoven with the Cold War—highlights the crucial importance of three factors: (1) the dynamically evolving macro-regional context, which has shaped transborder national membership politics in the region in distinctive ways; (2) the essentially political, performative, and constitutive nature of transborder nation-building; and (3) the role of state registration and documentation practices in shaping the contours of transborder national membership politics in the long run. By incorporating Korea—and East Asia more broadly—into the comparative study of transborder nation-building, this article also lays the groundwork for future cross-regional comparative historical studies. (shrink)

The ability of machines to make truly independent and autonomous decisions is a goal of many, not least of military leaders who wish to take the human out of the loop as much as possible, claiming that autonomous military weaponry—most notably drones—can make decisions more quickly and with greater accuracy. However, there is no clear understanding of how autonomous weapons should be conceptualized and of the implications that their “autonomous” nature has on them as ethical agents. It will be argued (...) that autonomous weapons are not full ethical agents due to the restrictions of their coding. However, the highly complex machine-learning nature gives the impression that they are making their own decisions and creates the illusion that their human operators are protected from the responsibility of the harm they cause. Therefore, it is important to distinguish between autonomous AI weapons and an AI with autonomy, a distinction that creates two different ethical problems for their use. For autonomous weapons, their limited agency combined with machine-learning means their human counterparts are still responsible for their actions while having no ability to control or intercede in the actual decisions made. If, on the other hand, an AI could reach the point of autonomy, the level of critical reflection would make its decisions unpredictable and dangerous in a weapon. (shrink)

The authors would like to correct a misspelling in the name of one of the authors due to a typographical error. The name should read Atur Turakhia, not Artur Turakhia. This does not change the conclusions or interpretations presented.

The Patient Self Determination Act of 1991 brought much needed attention to the importance of advance care planning and surrogate decision-making. The purpose of this law is to ensure that a patient’s preferences for medical care are recognized and promoted, even if the patient loses decision-making capacity. In general, patients are presumed to have DMC. A patient’s DMC may come under question when distortions in thinking and understanding due to illness, delirium, depression or other psychiatric symptoms are identified (...) or suspected. Physicians and other healthcare professionals working in hospital settings where medical illness is frequently comorbid with depression, adjustment disorders, demoralization and suicidal ideation, can expect to encounter ethical tension when medically sick patients who are also depressed or suicidal request do not resuscitate orders. (shrink)