Despite the promise of international collaboration and sharing by bringing together bioethicists from throughout the world at the 2024 IAB conference in Qatar, I will not be attending. The authors...

Digital medicine is a medical treatment that combines technology with drug delivery. The promises of this combination are continuous and remote monitoring, better disease management, self-tracking, self-management of diseases, and improved treatment adherence. These devices pose ethical challenges for patients, providers, and the social practice of medicine. For patients, having both informed consent and a user agreement raises questions of understanding for autonomy and informed consent, therapeutic misconception, external influences on decision making, confidentiality and privacy, and device dependability. For providers, (...) digital medicine changes the relationship where trust can be verified, clinicians can be monitored, expectations must be managed, and new liability risks may be assumed. Other ethical questions include direct third-party monitoring of health treatment, affordability, and planning for adverse events in the case of device malfunction. This article seeks to lay out the ethical landscape for the implementation of such devices in patient care. (shrink)

In “Artificial Intelligence, Social Media and Depression: A New Concept of Health-Related Digital Autonomy,” Laacke and colleagues posit a revised model of autonomy when using digital algori...

In October 2021, the Allen Institute for Artificial Intelligence publicly released Delphi, an artificial intelligence system trained to make general moral decisions (Allen Institute for Artifi...

Volume 20, Issue 10, October 2020, Page 29-31.

Although the AAMC requires annual reporting of medical humanities teaching, most literature is based on single-school case reports and studies using information reported on schools’ websites. This study sought to discover what medical humanities is offered in North American allopathic and osteopathic undergraduate medical schools. An 18-question, semi-structured survey was distributed to all 146 member schools of the American Association of Medical Colleges and the American Association of Colleges of Osteopathic Medicine. The survey sought information on required and elective humanities (...) content, hours of humanities instruction, types of disciplines, participation rates, and humanities administrative structure. The survey was completed by 134 schools. 70.8% of schools offered required and 80.6% offered electives in humanities. Global health and writing were the most common disciplines. Schools required 43.9 mean and 30 median hours in humanities. In the first two years, most humanities are integrated into other course work; most electives are offered as stand-alone classes. 50.0% of schools report only 0-25% of students participating in humanities electives. Presence of a certificate, concentration or arts journal increased likelihood of humanities content but decreased mean hours. Schools with a medical humanities MA had a higher number of required humanities hours. Medical humanities content in undergraduate curriculum is lower than is indicated in the AAMC annual report. Schools with a formal structure have a greater humanities presence in the curriculum and are taken by more students. (shrink)

In the last decade, the humanities have been shrinking in number of students, percent of faculty, and in number of degrees awarded. Humanities students also earn lower salaries than their STEM-prepared peers. At the same time, the health humanities have been in ascendance over the last fifteen years. The number of majors, minors and certificates has increased 266% in that time frame, attracting large numbers of students and preparing future patients, lay caregivers, and health care providers to interact with a (...) complicated and dehumanized medical system. In 1982, British philosopher and educator Stephen Toulmin declared that medicine saved philosophy from irrelevance and possibly extinction. I propose that the health humanities can serve a similar function to stave off the decline of the broader humanities. The health humanities can model an applied approach for the broader humanities to attract student interest; develop students’ capacity for critical reading, writing and reflection about health and medicine in society, practice, and their own lives and inoculate all students against the influence of medicine, whether through preparing pre-health students to navigate the hidden medical curriculum or preparing future patients to navigate the health care system. (shrink)

Academic programs in the medical/health humanities have proliferated widely in recent years, and the professional, academic, and cultural drivers of this growth promise sustained new program development. In this article, we present the results of a survey sent to representatives of one hundred twenty-four baccalaureate and ten graduate programs in the medical/health humanities to assess the experiences and needs of existing programs. Survey results confirm the interest in and need for a descriptive toolkit as opposed to a prescriptive manual; indicate (...) what data and materials are most needed to support the successful development of new academic programs in the field; and identify areas for future research. Recognizing a need for program development resources, the Health Humanities Consortium has initiated the creation of a comprehensive online toolkit. We discuss survey results and the toolkit in relation to the drivers of new program growth. Finally, we describe resources now available through the HHC’s new online program toolkit, including existing programs; sample syllabi; sample curricula templates; program rationale; proposal templates; and graduation data. (shrink)

The Health Humanities Consortium was established in 2015 to “promote health humanities scholarship, education, and practice through transdisciplinary methods and theories that focus on the intersection of the arts and humanities, health, illness, and healthcare.” As the founding co-chairs of the HHC, we provide a history of the founding of this organization in this article, describing the journey of its creation, the choices and challenges it faced as a new organization, and our hopes for a rich future.

In 2005, President George Bush read John Barry’s The Great Influenza: The Story of the Deadliest Pandemic in History. After his experiences of 9/11 and Hurricane Katrina, Bush began the first White...

The practice of psychology in rural areas offers unique challenges for psychologists as they try to provide optimal care, often with a minimum of resources. Psychologists are frequently required to be creative and flexible in order to provide effective services to a wide range of clients. However, these unique challenges often confront psychologists with ethical dilemmas and problems for which their urban-based training has not prepared them. The author examines how certain characteristics of rural communities may lead to specific ethical (...) dilemmas. By being a part of a small community, psychologists will inevitably face multiple relationship dilemmas. Confidentiality is harder to maintain in a small town, particularly with its informal information-sharing network. To provide services to meet community needs, with a limited number of referral options, psychologists typically need to be generalists. This may lead to concerns about scope of practice, training, and experience with diverse populations. Psychologists also face other competency issues, such as a lack of supervision and consultation resources. Other concerns addressed include the psychologist's visibility in the community, having clients know about the psychologist's personal life, and the blurring of professional and personal roles. Suggestions are made for coping with each of these ethical issues, although more quantitative research and discussion are needed on the practice of psychology in rural areas. (shrink)

Iraq: The Moral Reckoning is an intensive application of the six classic just war theory criteria to the 2003 Iraq war decision, weighing information available at the time from a wide range of sources and concluding that the war met just one of the six, whereas a just war should meet all. It supplements the criteria with widely used ethical principles and thoroughly refutes neoconservative arguments that the war met the criteria.

Much of the recent AI-LLM literature has been apocalyptic in pointing out the risks of AI technology, “mitigating the risk of extinction from AI should be a global priority alongside other societal...

While heightening the nihilistic tension underlying the discourse of Richard Kearney, I highlight the positive contribution his book The God Who May Be makes to the debate concerning the need for a postmodern revitalization of religious symbolism. I argue for three qualifications of Kearney's argument, suggesting, in response to Kearney's exclusionary approach to the God who “neither is nor is not but may be,” a God whose possibility for meaningfulness arises as an “eschatological theogony” from out of the chaos (confusion (...) and openness) of contemporary religious symbolism. Arguing that such a radical reenvisioning of God must be tempered and given meaning through reentering and reaffirming onto‐theology in a qualified (hermeneutical) sense, I sketch a possible renewal of meaning for the traditional Christian parousia‐concept as a hermeneutical circle between Hegel's systematic closure of Western metaphysics and Heidegger's deconstructive appropriation of the hidden possibilities of presence within the onto‐theological tradition. (shrink)

In their target article, Nelson, Lushkov, Pomerantz, and Weeks demonstrate that there has been a lack of discussion on rural bioethics issues in published, or at least indexed, literature. They con...

This paper examines the argument that scientific thinkers who embrace a religious tradition can promote intellectual integration between religion and science rather than fragmented discourse. It is argued that God’s Word as an event and the concept of structural directedness, an organized movement toward a future that does not demand a consciously intended end, may be helpful in understanding God’s actions in an indeterminant way.

In clinical ethics an enduring case takes on a life of its own and comes to closure over a long period of time. This essay describes the evolution of such a case over a 1–year period. The case involves a 90–year old male patient with multiple chronic medical conditions who lacked decision–making capacity, was a resident of a long–term care facility, and did not have known previously expressed wishes regarding medical treatment. The ethics consultation initially revolved around this question: What (...) method or process must be employed so that medical treatment decisions could be ethically reviewed and could include a shared decision–making process for Mr. Smith? This case analysis describes the evolution of this case and argues that the good of the patient must remain paramount throughout an enduring case. (shrink)

In the fall of 2021 a news story reported of a successful experimental xenotransplant of a genetically engineered pig kidney in to the circulatory system of a research subject who was dead by neurological criteria. Although not a first of its kind, this case raises the issue of the ethics of research on those declared brain dead. Such possibilities have been discussed in the published literature since 1974, when Willard Gaylin expressed concern over human dignity when he imagined hospital wards (...) filled with “neomorts” used for education, teaching, research, and manufacturing. In this essay, the author explores the nuances of whether such subjects are considered alive, dead, or something in between. Notions of consent/ permission and risk/benefit are determined by this categorization. After discussing the 2005 Consensus Panel Guidelines on Research with the Recently Dead, the essay concludes with the need for a liminal state between living and dead that respects human dignity but also recognizes the utilitarian value of such experiments to protect fully alive humans. Having not just guidelines but oversight structures such as the University of Pittsburgh’s Committee for Oversight of Research Involving the Dead (CORID) and regulations are necessary if such work is to become more common. (shrink)

Miguel is an eighteen‐year‐old male transferred to Alamo Hospital for antivenom treatment after a rattlesnake bite while sleeping on railroad tracks. His “coyote,” an individual who guides undocumented people across the U.S. border from Mexico, dropped him off at a clinic. By the time Miguel was transferred from the clinic to Alamo, he was in complete paralysis and at risk for heart failure, requiring ventilator support to breathe. A person who receives treatment for a snake bite within one to two (...) hours has a 99 percent chance of recovery, but for Miguel, at least fifteen hours had already passed. A hospital ethicist at Alamo contacted the Mexican consulate, and together they arranged for Miguel's father to come to Alamo and make decisions for him. His physicians have determined that he is in a persistent vegetative state and can no longer benefit from hospital treatment. However, no long‐term care facility will accept him. Miguel is undocumented and unfunded. Miguel's father wishes to take his son home, but the cost of transporting him is high,and their home state in Mexico has no ventilator available for him and no consistent supply of electricity to run it. What should the hospital do? (shrink)

The Macmillan Interdisciplinary Handbooks: Philosophy series serves undergraduate college students who have had little or no exposure to philosophy, as well as the curious lay reader. Following this first primer volume, which introduces both the discipline and the topics of the remaining nine volumes, each handbook will usher the reader into a subfield of philosophy (see list of titles below), and explore fifteen to thirty topics in that subfield. Every chapter in each volume will use vehicles such as film to (...) facilitate understanding of philosophical issues; for example, the film Dead Man Walking may be used as an introduction to issues related to the death penalty. (shrink)

This full-color book of photographs records Wisconsin from an unusual viewpoint: a camera suspended from a kite and controlled by photographer Craig M. Wilson from the ground. Taken from fifty to a few hundred feet in the air, Wilson’s photos capture natural and man-made views that wouldn’t otherwise be possible. The result is a vibrant collection that captures Wisconsin in all its shifting beauty in landscapes and cityscapes, festivals, Door County’s lighthouses, Milwaukee’s neighborhoods, and the crowd at a Badger (...) football game. Captions are provided in English, Spanish, German, and Mandarin Chinese. (shrink)

The authors conducted a baseline survey of baccalaureate and graduate degree health humanities programs in the United States and Canada. The object of the survey was to formally assess the current state of the field, to gauge what kind of resources individual programs are receiving, and to assess their self-identified needs to become or remain programmatically sustainable, including their views on the potential benefits of program accreditation. A 56-question baseline survey was sent to 111 institutions with baccalaureate programs and 20 (...) institutions with graduate programs. Respondents were asked about three areas: (1) program administration (managing unit, paid director, faculty lines, paid staff, funding sources); (2) educational program (curricular structure, CIP code usage, completion rates); and (3) views on accreditation for the field. A clear majority of respondents agreed that some form of accreditation or consultation service could address resource and sustainability issues. Overall, the survey responses to staffing, curricular structure, and support suggest the need for developing a sustainable infrastructure for health humanities. (shrink)

This book argues that the moral quality of an act comes from the agent's inner states. By arguing for the indispensable relevance of intention in the moral evaluation of acts, the book moves against a mainstream, 'objective' approach in normative ethics. It is commonly held that the intentions, knowledge, and volition of agents are irrelevant to the moral permissibility of their acts. This book stresses that the capacities of agency, rather than simply the label 'agent', must be engaged during an (...) act if its moral evaluation is to be coherent. The author begins with an ontological argument that an act is a motion or a causing of change in something else. He argues that the source of an act's moral meaning is in the agent: specifically, what the agent, if aware of relevant facts around her, aims to accomplish. He then moves to a series of critical chapters that consider arguments for mainstream approaches to act evaluation, including Thomson's dismissal of the agent knowledge and volition requirements, Scanlon's arguments for a derivative relevance of intentions to permissibility, Frowe's "causal roles" of agents in the moral evaluation of acts, and Bennett's explicit defense of the objective approach. The book concludes by offering the author's preferred replacement for the objective approach, an Aristotelian-Thomist view of acts. Acts, Intentions, and Moral Evaluation will be of interest to scholars and advanced students working in ethics, just war theory, the ethics of self-defense, and philosophy of action. (shrink)

The Aristotelian-Thomist claim is that external actions can be morally evaluated when they are voluntary (which includes being based on reasonably accurate knowledge of what an agent is doing), absent which, in effect, we evaluate outcomes, not acts. Also, in the Aristotelian-Thomist tradition the internal act of the will is paramount. These claims contrast with some current theorizing, e.g., by Judith Jarvis Thomson, that morally evaluates actions separately from agents, downplaying the internal act. Taking cases from current authors that revolve (...) around ignorance of key facts, I critique their theorizing on the basis of the nature of agency, the nature of abstraction, the moral language we use in describing acts, the need for reasonably complete descriptions of acts, and the tendency of act evaluations to “leak” into agent evaluations in objective theories. I then describe how Thomas Aquinas’s account of moral evaluation avoids these problems and provides a superior, multi-dimensional framework for moral evaluation. (shrink)

The Aristotelian-Thomist claim is that external actions can be morally evaluated when they are voluntary, absent which, in effect, we evaluate outcomes, not acts. Also, in the Aristotelian-Thomist tradition the internal act of the will is paramount. These claims contrast with some current theorizing, e.g., by Judith Jarvis Thomson, that morally evaluates actions separately from agents, downplaying the internal act. Taking cases from current authors that revolve around ignorance of key facts, I critique their theorizing on the basis of the (...) nature of agency, the nature of abstraction, the moral language we use in describing acts, the need for reasonably complete descriptions of acts, and the tendency of act evaluations to “leak” into agent evaluations in objective theories. I then describe how Thomas Aquinas’s account of moral evaluation avoids these problems and provides a superior, multi-dimensional framework for moral evaluation. (shrink)

Wilson combines his love of kites and photography to create this collection of photographs taken from on high. Using a camera strapped to a kite and his self-designed controlling devices, Wilson travels Wisconsin and its neighboring states to capture scenes with a unique view.

Data analytics, particularly the current rhetoric around “Big Data”, tend to be presented as new and innovative, emerging ahistorically to revolutionize modern life. In this article, we situate one branch of Big Data analytics, spatial Big Data, through a historical predecessor, geodemographic analysis, to help develop a critical approach to current data analytics. Spatial Big Data promises an epistemic break in marketing, a leap from targeting geodemographic areas to targeting individuals. Yet it inherits characteristics and problems from geodemographics, including a (...) justification through the market, and a process of commodification through the black-boxing of technology. As researchers develop sustained critiques of data analytics and its effects on everyday life, we must so with a grounding in the cultural and historical contexts from which data technologies emerged. This article and others develop a historically situated, critical approach to spatial Big Data. This history illustrates connections to the critical issues of surveillance, redlining, and the production of consumer subjects and geographies. The shared histories and structural logics of spatial Big Data and geodemographics create the space for a continued critique of data analyses’ role in society. (shrink)

In the rapidly evolving healthcare environment, perhaps no role is in greater flux and redefinition than that of the clinical bioethicist. The discussion of ethics consultation in the bioethics literature has moved from an ambiguous concern regarding its proper place in the clinical milieu to the more provocative question of which methods and theories should best characterize the intellectual and practical work it claims to do. The American Society for Bioethics and Humanities addressed these concerns in its 1998 report, CoreCompetenciesforHealthCareEthicsConsultation. (...) The report tries to answer the question as to what disciplinary training, background experience, and levels of knowledge in ethics the clinical ethics consultant should have, and what specific skills and character traits the clinical ethics consultant should cultivate. In addition to acquiring knowledge of common bioethical issues, theoretical concepts in ethical theory and moral reasoning, and health-related law and policy, the report also recommends that ethics consultants demonstrate knowledge of the health beliefs and perspectives of patients and healthcare providers. In our opinion, this recommendation underscores a crucial aspect of the practice of ethics consultation in the increasingly multicultural settings of healthcare institutions. Clearly, the dynamic of American life and culture is permeated with diversity and variety as new groups suffuse their own beliefs and faith perspectives into the health sector. New immigrant groups force society to question traditional healthcare practices and to accommodate changing medical needs. (shrink)

We examined the management of completed advance directives including why participants completed a document, what procedures and values they chose, with whom they held end-of-life conversations, and where they stored their document. Participants elected to complete a SurveyMonkey survey that was made available to individuals who wrote an advance directive through Texas-LivingWill.org; 491 individuals elected to fill out the survey, aged 19 to 94 years. The survey asked multiple questions about why participants completed an advance directive, where they would store (...) it, and with whom they had conversations about their end-oflife wishes. A list of procedures and values allowed participants to indicate what they refused or requested in their advance directive. Advance directives are most often completed to allow patients to prepare and control the healthcare they wish to receive when dying. One-half to two-thirds of individuals refuse common end-of-life medical procedures, and the rest request the procedures. We found a correlation between the choice to refuse or request a procedure and the age of the participant. Participants reported that their end-of-life conversations most often occurred with their spouse. Respondents often reported that their advance directive was stored with their physician and power of attorney for healthcare, conversations with those individuals rarely happened. Advance directives document patients’ requests for and refusals of end-of-life care. Physicians and surrogates need to be better educated so that the documents are part of a meaningful conversation with the patient. Because patients’ choices change over their lifespan, these documents need to be revisited regularly and not completed as a onetime event. (shrink)

In light of recent technological innovations and discourses around data and algorithmic analytics, scholars of many stripes are attempting to develop critical agendas and responses to these developments. In this mutual interview, three scholars discuss the stakes, ideas, responsibilities, and possibilities of critical data studies. The resulting dialog seeks to explore what kinds of critical approaches to these topics, in theory and practice, could open and make available such approaches to a broader audience.

Imitation recognition provides a viable platform from which advanced social cognitive skills may develop. Despite evidence that non-human primates are capable of imitation recognition, how this ability is related to social cognitive skills is unknown. In this study, we compared imitation recognition performance, as indicated by the production of testing behaviors, with performance on a series of tasks that assess social and physical cognition in 49 chimpanzees. In the initial analyses, we found that males were more responsive than females to (...) being imitated and engaged in significantly greater behavior repetitions and testing sequences. We also found that subjects who consistently recognized being imitated performed better on social but not physical cognitive tasks, as measured by the Primate Cognitive Test Battery. These findings suggest that the neural constructs underlying imitation recognition are likely associated with or among those underlying more general socio-communicative abilities in chimpanzees. Implications regarding how imitation recognition may facilitate other social cognitive processes, such as mirror self-recognition, are discussed. (shrink)