Decision making in health care contexts is often deeply challenging for the patients, their close ones, and those who care for them. All of them have and perceive different forms of responsibilitie...

In this paper, we first classify different types of second opinions and evaluate the ethical and epistemological implications of providing those in a clinical context. Second, we discuss the issue of how artificial intelligent could replace the human cognitive labour of providing such second opinion and find that several AI reach the levels of accuracy and efficiency needed to clarify their use an urgent ethical issue. Third, we outline the normative conditions of how AI may be used as second opinion (...) in clinical processes, weighing the benefits of its efficiency against concerns of responsibility attribution. Fourth, we provide a ‘rule of disagreement’ that fulfils these conditions while retaining some of the benefits of expanding the use of AI-based decision support systems in clinical contexts. This is because the rule of disagreement proposes to use AI as much as possible, but retain the ability to use human second opinions to resolve disagreements between AI and physician-in-charge. Fifth, we discuss some counterarguments. (shrink)

There is a remedy available for many of our ailments: Psychopharmacology promises to alleviate unsatisfying memory, bad moods, and low self-esteem. Bioethicists have long discussed the ethical implications of enhancement interventions. However, they have not considered relevant evidence from psychology and economics. The growth in autonomy in many areas of life is publicized as progress for the individual. However, the broadening of areas at one’s disposal together with the increasing individualization of value systems leads to situations in which the range (...) of options asks too much of the individual. I scrutinize whether increased self-determination and unbound possibilities are really in a person’s best interests. Evidence from psychology and economics challenges the assumption that unlimited autonomy is best in all cases. The responsibility for autonomous self-formation that comes with possibilities provided by neuro-enhancement developments can be a burden. To guarantee quality of life I suggest a balance of beneficence, support, and respect for autonomy. (shrink)

The increased presence of medical AI in clinical use raises the ethical question which standard of explainability is required for an acceptable and responsible implementation of AI-based applications in medical contexts. In this paper, we elaborate on the emerging debate surrounding the standards of explainability for medical AI. For this, we first distinguish several goods explainability is usually considered to contribute to the use of AI in general, and medical AI in specific. Second, we propose to understand the value of (...) explainability relative to other available norms of explainable decision-making. Third, in pointing out that we usually accept heuristics and uses of bounded rationality for medical decision-making by physicians, we argue that the explainability of medical decisions should not be measured against an idealized diagnostic process, but according to practical considerations. We conclude, fourth, to resolve the issue of explainability-standards by relocating the issue to the AI’s certifiability and interpretability. (shrink)

Addiction appears to be a deeply moralized concept. To understand the entwinement of addiction and morality, we briefly discuss the disease model and its alternatives in order to address the following questions: Is the disease model the only path towards a ‘de-moralized’ discourse of addiction? While it is tempting to think that medical language surrounding addiction provides liberation from the moralized language, evidence suggests that this is not necessarily the case. On the other hand non-disease models of addiction may seem (...) to resuscitate problematic forms of the moralization of addiction, including, invoking blame, shame, and the wholesale rejection of addicts as people who have deep character flaws, while ignoring the complex biological and social context of addiction. This is also not necessarily the case. We argue that a deficit in reasons responsiveness as basis for attribution of moral responsibility can be realized by multiple different causes, disease being one, but it also seems likely that alternative accounts of addiction as developed by Flanagan, Lewis, and Levy, may also involve mechanisms, psychological, social, and neurobiological that can diminish reasons responsiveness. It thus seems to us that nondisease models of addiction do not necessarily involve moralization. Hence, a non-stigmatizing approach to recovery can be realized in ways that are consistent with both the disease model and alternative models of addiction. (shrink)

Many recent AI policies have been structured under labels that follow a particular trend: national or international guidelines, policies or regulations, such as the EU’s and USA’s ‘Trustworthy AI’ and China’s and India’s adoption of ‘Responsible AI’, use a label that follows the recipe of [agentially loaded notion + ‘AI’]. A result of this branding, even if implicit, is to encourage the application by laypeople of these agentially loaded notions to the AI technologies themselves. Yet, these notions are appropriate only (...) when applied to agents, which current AI technologies are not; and the concern is that this misapplication creates an incentive to inappropriately attribute trustworthiness or responsibility to AI technologies. We endeavour to show that we have good reason to avoid any general AI policy that uses agentially loaded labelling. We suggest labelling these policies not in terms of some qualification of AI, but rather in terms of our approach to the technology and its wider development and use context – focusing on being trustworthy and responsible about AI, rather than on trustworthy or responsible AI. (shrink)

The American Journal of Bioethics, Volume 12, Issue 9, Page 53-55, September 2012.

Providing healthcare services frequently involves cognitively demanding tasks, including diagnoses and analyses as well as complex decisions about treatments and therapy. From a global perspective, ethically significant inequalities exist between regions where the expert knowledge required for these tasks is scarce or abundant. One possible strategy to diminish such inequalities and increase healthcare opportunities in expert-scarce settings is to provide healthcare solutions involving digital technologies that do not necessarily require the presence of a human expert, e.g., in the form of (...) artificial intelligent decision-support systems (AI-DSS). Such algorithmic decision-making, however, is mostly developed in resource- and expert-abundant settings to support healthcare experts in their work. As a practical consequence, the normative standards and requirements for such algorithmic decision-making in healthcare require the technology to be at least as explainable as the decisions made by the experts themselves. The goal of providing healthcare in settings where resources and expertise are scarce might come with a normative pull to lower the normative standards of using digital technologies in order to provide at least some healthcare in the first place. We scrutinize this tendency to lower standards in particular settings from a normative perspective, distinguish between different types of absolute and relative, local and global standards of explainability, and conclude by defending an ambitious and practicable standard of local relative explainability. (shrink)

Progress in Neuroscience advances rapidly and promises to change some of the basic concepts we have about ourselves. The field of Neuroethics is concerned with the resulting ethical implications. In this paper, we propose a framework to systematize the questions and positions in this context. We start with the discussion of three concrete cases around the topics of treatment/enhancement, personhood and privacy. For each case, we get a set of axes along which standpoints may vary. Finally, we generalize the particular (...) axes of each case and arrive at a three-dimensional coordinate system spanned by the axes of “Liberty of Denial”, “Liberty of Use” and “Scepticism”. With this, we hope to provide a common language simplifying interdisciplinary dialogue and communication with the public. (shrink)

Medical decision-making on behalf of intellectually and developmentally disabled (IDD) patients amounts to a critical challenge, one which has been widely discussed by bioethicists, medical, and le...

This paper explores the role and resolution of disagreements between physicians and their diagnostic AI-based decision support systems. With an ever-growing number of applications for these independently operating diagnostic tools, it becomes less and less clear what a physician ought to do in case their diagnosis is in faultless conflict with the results of the DSS. The consequences of such uncertainty can ultimately lead to effects detrimental to the intended purpose of such machines, e.g. by shifting the burden of proof (...) towards a physician. Thus, we require normative clarity for integrating these machines without affecting established, trusted, and relied upon workflows. In reconstructing different causes of conflicts between physicians and their AI-based tools—inspired by the approach of “meaningful human control” over autonomous systems and the challenges to resolve them—we will delineate normative conditions for “meaningful disagreements”. These incorporate the potential of DSS to take on more tasks and outline how the moral responsibility of a physician can be preserved in an increasingly automated clinical work environment. (shrink)

Volume 20, Issue 8, August 2020, Page 83-85.

Robotic and artificially intelligent (AI) systems are becoming prevalent in our day-to-day lives. As human interaction is increasingly replaced by human–computer and human–robot interaction (HCI and HRI), we occasionally speak and act as though we are blaming or praising various technological devices. While such responses may arise naturally, they are still unusual. Indeed, for some authors, it is the programmers or users—and not the system itself—that we properly hold responsible in these cases. Furthermore, some argue that since directing blame or (...) praise at technology itself is unfitting, designing systems in ways that encourage such practices can only exacerbate the problem. On the other hand, there may be good moral reasons to continue engaging in our natural practices, even in cases involving AI systems or robots. In particular, daily interactions with technology may stand to impact the development of our moral practices in human-to-human interactions. In this paper, we put forward an empirically grounded argument in favor of some technologies being designed for social responsiveness. Although our usual practices will likely undergo adjustments in response to innovative technologies, some systems which we encounter can be designed to accommodate our natural moral responses. In short, fostering HCI and HRI that sustains and promotes our natural moral practices calls for a co-developmental process with some AI and robotic technologies. (shrink)

We argue that brains generate predictions only within the constraints of the action repertoire. This makes the computational complexity tractable and fosters a step-by-step parallel development of sensory and motor systems. Hence, it is more of a benefit than a literal constraint and may serve as a universal normative principle to understand sensorimotor coupling and interactions with the world.

ZusammenfassungFünfzehn Jahre nach ihrer Entstehung ist die Neuroethik ein internationales wissenschaftliches Feld mit enormer Dynamik. Innerhalb weniger Jahre wurden eigene Kongresse, Zeitschriften, Forschungsförderprogramme, Fachgesellschaften und Institute gegründet. Gleichwohl besteht erheblicher Dissens über die Definition und den Gegenstandsbereich dieses neuen Gebiets. Wir argumentieren hier für eine differenzierte Konzeption, wonach neben der Reflexion ethischer Probleme der Neurowissenschaft und ihrer überwiegend neurotechnologischen Anwendungen auch die ethische Reflexion neurowissenschaftlicher Forschung zur Moralität zur Neuroethik gehört. Dies umfasst zwar nicht neurowissenschaftliche oder neuropsychologische Studien zur Moralität, (...) wohl aber die Reflexion der Bedeutung dieser Forschung für die Ethik und das Recht. Wir geben einen Überblick über die wichtigsten Themen der Neuroethik, woraus deutlich wird, wie sehr in verschiedenen gesellschaftlichen Bereichen, auch jenseits von Medizin und Gesundheitswesen, neuroethische Fragen relevant sind. Das Potenzial der Neuroethik als eines neuen Wissenschaftsfeldes liegt darin, durch eine Verknüpfung neurophilosophischer und medizinethischer Themen sowie eine breite interdisziplinäre Vernetzung neue Antworten auf gesellschaftlich drängende Fragen zu finden. (shrink)

Cognitive science is experiencing a pragmatic turn away from the traditional representation-centered framework toward a view that focuses on understanding cognition as "enactive." This enactive view holds that cognition does not produce models of the world but rather subserves action as it is grounded in sensorimotor skills. In this volume, experts from cognitive science, neuroscience, psychology, robotics, and philosophy of mind assess the foundations and implications of a novel action-oriented view of cognition. Their contributions and supporting experimental evidence show that (...) an enactive approach to cognitive science enables strong conceptual advances, and the chapters explore key concepts for this new model of cognition. The contributors discuss the implications of an enactive approach for cognitive development; action-oriented models of cognitive processing; action-oriented understandings of consciousness and experience; and the accompanying paradigm shifts in the fields of philosophy, brain science, robotics, and psychology. ContributorsMoshe Bar, Lawrence W. Barsalov, Olaf Blanke, Jeannette Bohg, Martin V. Butz, Peter F. Dominey, Andreas K. Engel, Judith M. Ford, Karl J. Friston, Chris D. Frith, Shaun Gallagher, Antonia Hamilton, Tobias Heed, Cecilia Heyes, Elisabeth Hill, Matej Hoffmann, Jakob Hohwy, Bernhard Hommel, Atsushi Iriki, Pierre Jacob, Henrik Jörntell, Jürgen Jost, James Kilner, Günther Knoblich, Peter König, Danica Kragic, Miriam Kyselo, Alexander Maye, Marek McGann, Richard Menary, Thomas Metzinger, Ezequiel Morsella, Saskia Nagel, Kevin J. O'Regan, Pierre-Yves Oudeyer, Giovanni Pezzulo, Tony J. Prescott, Wolfgang Prinz, Friedemann Pulvermüller, Robert Rupert, Marti Sanchez-Fibla, Andrew Schwartz, Anil K. Seth, Vicky Southgate, Antonella Tramacere, John K. Tsotsos, Paul F. M. J. Verschure, Gabriella Vigliocco, Gottfried Vosgerau. (shrink)

This paper tries to clarify, strengthen and respond to two prominent objections to the development and use of human enhancement technologies. Both objections express concerns about the link between enhancement and the drive for hyperagency. The first derives from the work of Sandel and Hauskeller—and is concerned with the negative impact of hyperagency on social solidarity. In responding to their objection, I argue that although social solidarity is valuable, there is a danger in overestimating its value and in neglecting some (...) obvious ways in which the enhancement project can be planned so as to avoid its degradation. The second objection, though common to several writers, has been most directly asserted by Saskia Nagel, and is concerned with the impact of hyperagency on the burden and distribution of responsibility. Though this is an intriguing objection, I argue that not enough has been done to explain why this is morally problematic. I try to correct for this flaw before offering a variety of strategies for dealing with the problems raised. (shrink)

New fetal therapies offer important prospects for improving health. However, having to consider both the fetus and the pregnant woman makes the risk–benefit analysis of fetal therapy trials challenging. Regulatory guidance is limited, and proposed ethical frameworks are overly restrictive or permissive. We propose a new ethical framework for fetal therapy research. First, we argue that considering only biomedical benefits fails to capture all relevant interests. Thus, we endorse expanding the considered benefits to include evidence-based psychosocial effects of fetal therapies. (...) Second, we reject the commonly proposed categorical risk and/or benefit thresholds for assessing fetal therapy research. Instead, we propose that the individual risks for the pregnant woman and the fetus should be justified by the benefits for them and the study’s social value. Studies that meet this overall proportionality criterion but have mildly unfavorable risk–benefit ratios for pregnant women and/or fetuses may be acceptable. (shrink)

Novice designers produced a sequence of sketches while inventing a logo for a novel brand of soft drink. The sketches were scored for the presence of specific objects, their local features and global composition. Self‐assessment scores for each sketch and art critics' scores for the end products were collected. It was investigated whether the design evolves in an essentially random fashion or according to an overall heuristic. The results indicated a macrostructure in the evolution of the design, characterized by two (...) stages. For the majority of participants, the first stage is marked by the introduction and modification of novel objects and their local and global aspects; the second stage is characterized by changes in their global composition. The minority that showed the better designs has a different strategy, in which most global changes were made in the beginning. Although participants did not consciously apply these strategies, their self‐assessment scores reflect the stages of the process. (shrink)

Novice designers produced a sequence of sketches while inventing a logo for a novel brand of soft drink. The sketches were scored for the presence of specific objects, their local features and global composition. Self‐assessment scores for each sketch and art critics' scores for the end products were collected. It was investigated whether the design evolves in an essentially random fashion or according to an overall heuristic. The results indicated a macrostructure in the evolution of the design, characterized by two (...) stages. For the majority of participants, the first stage is marked by the introduction and modification of novel objects and their local and global aspects; the second stage is characterized by changes in their global composition. The minority that showed the better designs has a different strategy, in which most global changes were made in the beginning. Although participants did not consciously apply these strategies, their self‐assessment scores reflect the stages of the process. (shrink)

"The importance of the justification of our beliefs is a long-debated question. The question of how our memory beliefs are justified, however, is a question we have usually neglected as our memory does not seem to draw much attention to itself. As long as it works, we do not even notice that we use it most of the time. In my opinion, the question of how our memory beliefs are justified, however, should play a bigger role in the philosophical debate. (...) The reason for this claim is that most of our beliefs are memory beliefs. A position I will argue for in this paper. Based on empirical findings in Cognitive Science, I will explain that our memory is not only involved in forming beliefs about the past but more controversially in forming beliefs about the present, in reasoning processes and even more controversially in forming beliefs about the future. If beliefs about what has been, about what is the case in the present and even about what will have been the case in the future are memory beliefs, reconsidering our strict focus on the justification of mere beliefs seems to be a change in debate worth considering. Keywords: Memory, Philosophy of Memory, Belief, Cognitive Science, Epistemology of Memory, Philosophy of Cognitive Science". (shrink)

Factive mental states, such as knowing or being aware, can only link an agent to the truth; by contrast, nonfactive states, such as believing or thinking, can link an agent to either truths or falsehoods. Researchers of mental state attribution often draw a sharp line between the capacity to attribute accurate states of mind and the capacity to attribute inaccurate or “reality-incongruent” states of mind, such as false belief. This article argues that the contrast that really matters for mental state (...) attribution does not divide accurate from inaccurate states, but factive from nonfactive ones. (shrink)

When and why does it matter whether we can give an explicit justification for what we believe? This paper examines these questions in the light of recent empirical work on the social functions served by our capacity to reason, in particular, Mercier and Sperber’s argumentative theory of reasoning.

This paper discusses different ways of formulating regulation that takes into account a responsibility towards future generations in environmental issues. A rights-based or human-rights based approach, based on notions of intergenerational equity, can be problematic on a conceptual level, and implementation of rights for future generations is challenging. An alternative approach is based on the assignment of duties to present generations rather than rights of future generations. This approach, which is often used in regulation concerning sustainability, uses goal regulation to (...) avoid conceptual problems with rights of future generations while it still provides the opportunity to safeguard their interests and needs. (shrink)

The biggest contemporary challenge to democratic legitimacy gravitates around the crisis of democratic representation.

Exponential-constructible functions are an extension of the class of constructible functions. This extension was formulated by Cluckers and Loeser in the context of semi-algebraic and sub-analytic structures, when they studied stability under integration. In this paper, we will present a natural refinement of their definition that allows for stability results to hold within the wider class of [Formula: see text]-minimal structures. One of the main technical improvements is that we remove the requirement of definable Skolem functions from the proofs. As (...) a result, we obtain stability in particular for all intermediate structures between the semi-algebraic and the sub-analytic languages. (shrink)

Zugänge zum Begriff des Erinnerungsortes -- Beethovens neunte Symphonie -- Rock and Roll Hall of Fame and Museum -- Mozart und Graz -- Genre Hiphop -- Scharouns Philharmonie und Libeskinds Jüdisches Museum in Berlin -- Geschichte und Gegenwart in der Gemeinschaft.