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)

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)

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)

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)

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...

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

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)

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)

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)

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)

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.

This book is a fiftieth anniversary republication of Thomas Nagel's "What Is It Like to Be a Bat?", a classic in the philosophy of mind. Through its argument for the irreducible subjectivity of consciousness, it played an essential role in making the study of consciousness a central part of philosophy, psychology, and neuroscience. It also spurred the now flourishing scientific attention to the consciousness of non-human creatures: mammals, birds, fish, mollusks, and insects. The book also includes a second essay (...) offering Nagel's more recent thoughts on the most promising positive response to the mind-body problem, as posed in the original essay. (shrink)

In 1931 the mathematical logician Kurt Godel published a revolutionary paper that challenged certain basic assumptions underpinning mathematics and logic. A colleague of Albert Einstein, his theorem proved that mathematics was partly based on propositions not provable within the mathematical system and had radical implications that have echoed throughout many fields. A gripping combination of science and accessibility, _Godel’s Proof_ by Nagel and Newman is for both mathematicians and the idly curious, offering those with a taste for logic and (...) philosophy the chance to satisfy their intellectual curiosity. (shrink)

Once symbolized by a burning armchair, experimental philosophy has in recent years shifted away from its original hostility to traditional methods. Starting with a brief historical review of the experimentalist challenge to traditional philosophical practice, this chapter looks at research undercutting that challenge, and at ways in which experimental work has evolved to complement and strengthen traditional approaches to philosophical questions.

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)

Intuitively, there is a difference between knowledge and mere belief. Contemporary philosophical work on the nature of this difference has focused on scenarios known as “Gettier cases.” Designed as counterexamples to the classical theory that knowledge is justified true belief, these cases feature agents who arrive at true beliefs in ways which seem reasonable or justified, while nevertheless seeming to lack knowledge. Prior empirical investigation of these cases has raised questions about whether lay people generally share philosophers’ intuitions about these (...) cases, or whether lay intuitions vary depending on individual factors (e.g. ethnicity) or factors related to specific types of Gettier cases (e.g. cases that include apparent evidence). We report an experiment on lay attributions of knowledge and justification for a wide range of Gettier Cases and for a related class of controversial cases known as Skeptical Pressure cases, which are also thought by philosophers to elicit intuitive denials of knowledge. Although participants rated true beliefs in Gettier and Skeptical Pressure cases as being justified, they were significantly less likely to attribute knowledge for these cases than for matched true belief cases. This pattern of response was consistent across different variations of Gettier cases and did not vary by ethnicity or gender, although attributions of justification were found to be positively related to measures of empathy. These findings therefore suggest that across demographic groups, laypeople share similar epistemic concepts with philosophers, recognizing a difference between knowledge and justified true belief. (shrink)

Michael Bergmann’s important new book on scepticism is attractively systematic and thorough. He places familiar ideas under an exceptionally bright spotlight, e.

Because knowledge entails true belief, it is can be hard to explain why a given action is naturally seen as driven by one of these states as opposed to the other. A simpler and more radical characterization of knowledge helps to solve this problem while also shedding some light on what is special about social learning.

Do epistemic intuitions tell us anything about knowledge? Stich has argued that we respond to cases according to our contingent cultural programming, and not in a manner that tends to reveal anything significant about knowledge itself. I’ve argued that a cross-culturally universal capacity for mindreading produces the intuitive sense that the subject of a case has or lacks knowledge. This paper responds to Stich’s charge that mindreading is cross-culturally varied in a way that will strip epistemic intuitions of their evidential (...) value. I argue that existing work on cross-cultural variation in mindreading favors my position over Stich’s. (shrink)

Curiosity is evident in humans of all sorts from early infancy, and it has also been said to appear in a wide range of other animals, including monkeys, birds, rats, and octopuses. The classical definition of curiosity as an intrinsic desire for knowledge may seem inapplicable to animal curiosity: one might wonder how and indeed whether a rat could have such a fancy desire. Even if rats must learn many things to survive, one might expect their learning must be driven (...) by simpler incentives, such as hunger. One might also wonder what proximal signals could guide animals towards knowledge itself, or how something as abstract as knowledge could ever be a motivational target for an unreflective animal. Taking a cue from recent work in reinforcement learning, I argue that surprise functions as a reward signal for the curious animal, and then show how this amounts to a desire for knowledge gain, where knowledge is conceived of as a cognitive adaptation to reality. This adaptation results in a mental state whose existence depends essentially on the truth of its contents, a factive mental state. Curious creatures benefit from an interaction between the prediction-error correction processes of basic learning and the active surprise-seeking force of their curiosity. This internally adversarial interaction accelerates knowledge gain in ways that are very helpful for agents with the restrictions of biological creatures, in environments with the complexity of our natural world. (shrink)

To what extent should we trust our natural instincts about knowledge? The question has special urgency for epistemologists who want to draw evidential support for their theories from certain intuitive epistemic assessments while discounting others as misleading. This paper focuses on the viability of endorsing the legitimacy of Gettier intuitions while resisting the intuitive pull of skepticism – a combination of moves that most mainstream epistemologists find appealing. Awkwardly enough, the “good” Gettier intuitions and the “bad” skeptical intuitions seem to (...) be equally strong. This chapter argues that it is not a coincidence that these two types of intuition register with equal force: they are generated by a common mechanism. However, the input to this mechanism is interestingly different in the two types of case, and different in a way that can support the mainstream view that Gettier cases tell us something about knowledge where skeptical intuitions involve systematic error. (shrink)

Over the past twenty-five years, Thomas Nagel has played a major role in the philosophico-biological debate on subjectivity and consciousness. This extensive collection of published essays and reviews offers Nagel's opinionated views on the philosophy of mind, epistemology, and political philosophy, as well as on fellow philosophers like Freud, Wittgenstein, Rawls, Dennet, Chomsky, Searle, Nozick, Dworkin, and MacIntyre.

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)

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)

I. The Mind-Body Problem after Kripke This essay will explore an approach to the mind-body problem that is distinct both from dualism and from the sort of conceptual reduction of the mental to the physical that proceeds via causal behaviorist or functionalist analysis of mental concepts. The essential element of the approach is that it takes the subjective phenomenological features of conscious experience to be perfectly real and not reducible to anything else--but nevertheless holds that their systematic relations to neurophysiology (...) are not contingent but necessary. (shrink)

This brief essay examines emergent spaces for politics and emergent political actors. The particular concern here is with types of politics that do not run through the formal political system, one with shrinking options for a growing number of US citizens and immigrants. Informal political actors and street-level politics in cities are major instances of this. US cities have a long history of street-level politics. The contents, the purposes, the mobilizers and the enactors of these politics have changed over time. (...) Today’s global cities are a very specific type of place because they bring together both the most globalized sectors of capital and the new transnational professionals, on the one hand, and a growing number of immigrants and native minoritized groups in a single, complex space. (shrink)