Integrating large language models (LLMs) like GPT-4 into medical ethics is a novel concept, and understanding the effectiveness of these models in aiding ethicists with decision-making can have significant implications for the healthcare sector. Thus, the objective of this study was to evaluate the performance of GPT-4 in responding to complex medical ethical vignettes and to gauge its utility and limitations for aiding medical ethicists. Using a mixed-methods, cross-sectional survey approach, a panel of six ethicists assessed LLM-generated responses to eight (...) ethical vignettes.The main outcomes measured were relevance, reasoning, depth, technical and non-technical clarity, as well as acceptability of GPT-4’s responses. The readability of the responses was also assessed. Of the six metrics evaluating the effectiveness of GPT-4’s responses, the overall mean score was 4.1/5. GPT-4 was rated highest in providing technical (4.7/5) and non-technical clarity (4.4/5), whereas the lowest rated metrics were depth (3.8/5) and acceptability (3.8/5). There was poor-to-moderate inter-rater reliability characterised by an intraclass coefficient of 0.54 (95% CI: 0.30 to 0.71). Based on panellist feedback, GPT-4 was able to identify and articulate key ethical issues but struggled to appreciate the nuanced aspects of ethical dilemmas and misapplied certain moral principles.This study reveals limitations in the ability of GPT-4 to appreciate the depth and nuanced acceptability of real-world ethical dilemmas, particularly those that require a thorough understanding of relational complexities and context-specific values. Ongoing evaluation of LLM capabilities within medical ethics remains paramount, and further refinement is needed before it can be used effectively in clinical settings. (shrink)

Studies in Stoicism contains six unpublished and seven republished essays, the latter incorporating additions and changes which Brunt wished to be made. The papers have been integrated and arranged in chronological order by subject matter, with an accessible lecture to the Oxford Philological Society serving as Brunt's own introduction.

[T]he essays collected here... further determine the limits of experience as well as salvage something essential from that which takes place at the very limit of political and aesthetic experience. Included here are critical readings of such seminal figures as Locke, Kant, Nietzsche, Adorno, Foucault, Fanon, Lacoue-Labarthe, Badiou, and Rancière." -Cover.

In the minds of many, Hox gene null mutant phenotypes have confirmed the direct role that these genes play in specifying the pattern of vertebrate embryos. The genes are envisaged as defining discrete spatial domains and, subsequently, conferring specific segmental identities on cells undergoing differentiation along the antero‐posterior axis. However, several aspects of the observed mutant phenotypes are inconsistent with this view. These include: the appearance of other, unexpected transformations along the dorsal axis; the occurrence of mirror‐image duplications; and the (...) development of anomalies outside the established domains of normal Hox gene expression. In this paper, Hox gene disruptions are shown to elicit regeneration‐like responses in tissues confronted with discontinuities in axial identity. The polarities and orientations of transformed segments which emerge as a consequence of this response obey the rules of distal transformation and intercalary regeneration. In addition, the incidence of periodic anomalies suggests that the initial steps of Hox‐mediated patterning occurs in Hensen's node. As gastrulation proceeds, mesoderm cell cycle kinetics impose constraints upon subsequent cellular differentiation. This results in the delayed manifestation of transformations along the antero‐posterior axis. Finally, a paradigm is sketched in which temporal, rather than spatial axial determinants direct differentiation. Specific, testable predictions are made about the role of Hox genes in the establishment of segmental identity. (shrink)

The ability to quickly and accurately recognise emotional states is adaptive for numerous social functions. Although body movements are a potentially crucial cue for inferring emotions, few studies have studied the perception of body movements made in naturalistic emotional states. The current research focuses on the use of body movement information in the perception of fear expressed by targets in a virtual heights paradigm. Across three studies, participants made judgments about the emotional states of others based on motion-capture body movement (...) recordings of those individuals actively engaged in walking a virtual plank at ground-level or 80 stories above a city street. Results indicated that participants were reliably able to differentiate between height and non-height conditions (Studies 1 & 2), were more likely to spontaneously describe target behaviour in the height condition as fearful (Study 2) and their fear estimates were highly calibrated with the fear ratings from the targets (Studies 1-3). Findings show that VR height scenarios can induce fearful behaviour and that people can perceive fear in minimal representations of body movement. (shrink)

The essays in this volume all originated at the 2001 conference of the International Society for the Study of Time.

The aim of this study is to assess patients' recall of their previous research participation. Recall was established during interviews and compared with entries from clinical notes. Participants were 49 patients who had previously participated in different types of research. Of the 49 patients, 45 (92%) interviewees recalled 69 of 109 (63%) study participations. Level of recall varied according to the type of research, some participants clearly recalled the details of research aims, giving consent and research procedures. Others recalled procedures (...) (e.g. DNA testing) but were unclear about their purpose. There was no significant effect of time on recall. Some types of research participation (e.g. DNA testing) may be recalled as clinical care. We argue that such misunderstandings may have the potential to undermine participants' ongoing consent, particularly in ongoing/longitudinal studies. Valid consent may be best achieved by re-assessing the scope of consent and relating it to the nature of the interventions themselves rather than the reasons for undertaking them. (shrink)

The objective of this study is to describe researchers', health-care providers' and other stakeholders' views of ethical review and research governance procedures. The study design involved qualitative semi-structured interviews. Participants included 60 individuals who either undertook research in the subspecialty of cancer genetics (n = 40) or were involved in biomedical research in other capacities (n = 20), e.g. research governance and oversight, patient support groups or research funding. While all interviewees observed that oversight is necessary to protect research participants, (...) ethical review and research governance (ERG) arrangements were described negatively throughout these interviews. Interviewees identified a number of problems with ERG, including: over-bureaucratization, over-standardization of information requirements for different types of research, a lack of standardization in the types of information required by different committees for the same research and a lack of consistency in different committees' responses. A number of solutions were proposed including streamlining application procedures and harmonizing committees' responses and information requirements. Recent reports suggest that ethical review procedures and research governance arrangements threaten the possibility of undertaking clinical research in the UK, hence the introduction of the Integrated Research Application System (IRAS) is long overdue. However, while IRAS may solve some of the problems identified by interviewees, it remains to be seen to what extent it will impact upon the very negative perceptions of ethics and research governance procedures reported here. (shrink)

This paper examines the concept of ‘openness with patients’ from the stand-point of the limitations of biomedical ethics. Initially we review contemporary critiques of bioethics and, in particular, of principlism; we relate how other; somewhat neglected, forms of medical ethics can yield useful information and provide moral guidance. The main section of the paper then shows how a bioethical approach to openness misses the social context in our example, the viewpoints of patients; we present some of the increasing wealth of (...) research evidence which points towards patients wanting more information and a greater degree of openness. (shrink)

Time and Memory comprises essays that deal with the nature of memory as a medium that reflects the passage of time, as a tool for the manipulation of time, and as a reflection of the creative and destructive impulse.

Name der Zeitschrift: Der Islam Jahrgang: 94 Heft: 1 Seiten: 284-287.

This paper examines the concept of ‘openness with patients’ from the stand-point of the limitations of biomedical ethics. Initially we review contemporary critiques of bioethics and, in particular, of principlism; we relate how other; somewhat neglected, forms of medical ethics can yield useful information and provide moral guidance.The main section of the paper then shows how a bioethical approach to openness misses the social context in our example, the viewpoints of patients; we present some of the increasing wealth of research (...) evidence which points towards patients wanting more information and a greater degree of openness.Finally we put forward that a principlist’s objection to active encouragement of openness might be based on the risk of infringing upon the ‘right not to know’. We reject this by arguing how rights can be trumped. (shrink)

Propositionalism is the view that intentional attitudes, such as belief, are relations to propositions. Propositionalists argue that propositionalism follows from the intuitive validity of certain kinds of inferences involving attitude reports. Jubien (2001) argues powerfully against propositions and sketches some interesting positive proposals, based on Russell’s multiple relation theory of judgment, about how to accommodate “propositional phenomena” without appeal to propositions. This paper argues that none of Jubien’s proposals succeeds in accommodating an important range of propositional phenomena, such as the (...) aforementioned validity of attitude-report inferences. It then shows that the notion of a predication act-type, which remains importantly Russellian in spirit, is sufficient to explain the range of propositional phenomena in question, in particular the validity of attitude-report inferences. The paper concludes with a discussion of whether predication act-types are really just propositions by another name. (shrink)

This paper attacks an account of Kant's controversial distinction between "free" and "dependent" beauty. I present three problems—The Lorland problem, The Crawford Problem, and the problem of intrinsic relation—that are shown to be a consequence of various interpretations of Kant's distinction. Next, I reconstruct Robert Wicks' well-known account of dependent beauty as "the appreciation of teleological style" and point out a key equivocation in the statement of Wicks' account: the judgment of dependent beauty can be thought to consist in (...) comparing any two objects' teleological styles either in respect of how or in respect of how well each realizes a common purpose. I argue that this equivocation forces Wicks into a dilemma: either he must assert the impossibility of ugliness or he must assert that the judgment of dependent beauty is reducible to the judgment of perfection. Either way, he denies important theoretic desiderata. (shrink)

Our aim in this paper is to present the distinct ways in which Wolff, Baumgarten, and Kant understand the relationship between necessitation, constraint, and reluctant action in an effort to illustrate the subtle ways in which their conceptions of obligation differ from each another. Whereas Wolff conceives of natural or moral obligation as incompatible with constraint, Baumgarten holds that constraint and reluctant action are, in some instances, compatible with natural obligation. Kant departs from Baumgarten by conceiving of obligation as necessarily (...) involving constraint: as Kant’s reply to Schiller’s famous objection reveals, obligation must take on the character of constraint to reluctant action on account of the fact that human beings possess inclinations that always threaten to impel them in directions that oppose morality. (shrink)

Concepts and Cases in Nursing Ethics is an introduction to contemporary ethical issues in health care, designed especially for Canadian audiences. The book is organized around six key concepts: beneficence, autonomy, truth-telling, confidentiality, justice, and integrity. Each of these concepts is explained and discussed with reference to professional and legal norms. The discussion is then supplemented by case studies that exemplify the relevant concepts and show how each applies in health care and nursing practice. This new fourth edition includes an (...) added chapter on end-of-life issues, and it is revised throughout to reflect the latest developments on topics such as global health ethics, cultural competence, social media, and palliative sedation. (shrink)

According to the received account of guilt in the philosophical literature, one cannot feel guilt unless one takes oneself to have done something morally wrong. But ordinary people feel guilt in many cases in which they do not take themselves to have done anything morally wrong. In this paper, I focus on one kind of guilt without perceived wrongdoing, guilt about being merely causally responsible for a bad state-of-affairs. I go on to present a novel account of guilt that explains (...) guilt about mere causal responsibility, according to which guilt represents part of the self as bound up with what is bad. (shrink)

An Essay on Human Action seeks to provide a comprehensive, detailed, enlightening, and (in its detail) original account of human action. This account presupposes a theory of events as abstract, proposition-like entities, a theory which is given in the first chapter of the book. The core-issues of action-theory are then treated: what acting in general is (a version of the traditional volitional theory is proposed and defended); how actions are to be individuated; how long actions last; what acting intentionally is; (...) what doing one thing by doing another is; what basic action is; and what omitting to do something is. Attention is also given to the concepts of causation, intention, volition, deciding, choosing, and trying. Finally, a libertarian account of free action is tentatively proposed and defended. (shrink)