Current national and international guidelines for the ethical design and development of artificial intelligence (AI) and robotics emphasize ethical theory. Various governing and advisory bodies have generated sets of broad ethical principles, which institutional decisionmakers are encouraged to apply to particular practical decisions. Although much of this literature examines the ethics of designing and developing AI and robotics, medical institutions typically must make purchase and deployment decisions about technologies that have already been designed and developed. The primary problem facing medical (...) institutions is not one of ethical design but of ethical deployment. The purpose of this paper is to develop a practical model by which medical institutions may make ethical deployment decisions about ready-made advanced technologies. Our slogan is “more process, less principles.” Ethically sound decisionmaking requires that the process by which medical institutions make such decisions include participatory, deliberative, and conservative elements. We argue that our model preserves the strengths of existing frameworks, avoids their shortcomings, and delivers its own moral, practical, and epistemic advantages. (shrink)

Nurses have traditionally been regarded as clinicians that deliver compassionate, safe, and empathetic health care (Nurses again outpace other professions for honesty & ethics, 2018). Caring is a fundamental characteristic, expectation, and moral obligation of the nursing and caregiving professions (Nursing: Scope and standards of practice, American Nurses Association, Silver Spring, MD, 2015). Along with caring, nurses are expected to undertake ever‐expanding duties and complex tasks. In part because of the growing physical, intellectual and emotional demandingness, of nursing as well (...) as technological advances, artificial intelligence (AI) and AI care robots are rapidly changing the healthcare landscape. As technology becomes more advanced, efficient, and economical, opportunities and pressure to introduce AI into nursing care will only increase. In the first part of the article, we review recent and existing applications of AI in nursing and speculate on future use. Second, situate our project within the recent literature on the ethics of nursing and AI. Third, we explore three dominant theories of caring and the two paradigmatic expressions of caring (touch and presence) and conclude that AI—at least for the foreseeable future—is incapable of caring in the sense central to nursing and caregiving ethics. We conclude that for AI to be implemented ethically, it cannot transgress the core values of nursing, usurp aspects of caring that can only meaningfully be carried out by human beings, and it must support, open, or improve opportunities for nurses to provide the uniquely human aspects of care. (shrink)

The rapid progress and expanding development of machine learning-driven clinical decision support systems (ML_CDSS) have led to calls for involving “humans in the loop” in the design, development,...

The views on plagiarism of 574 students at four Australian universities operating in Singapore were investigated through a survey and interviews. Analysis of students’ responses to different plagiarism scenarios revealed misconceptions and uncertainties about many aspects of plagiarism. Self-plagiarism and reuse of a friend’s work were acceptable to more than one quarter of the students, and nearly half considered collusion to be a legitimate form of collaboration. One quarter of the students also indicated that they would knowingly plagiarize. This should (...) serve as a wake-up call regarding plagiarism in transnational higher education. Seven measures are recommended to curb plagiarism and foster academic integrity. (shrink)

ChatGPT – a large language model – recently passed the U.S. bar exam. The startling rise and power of generative artificial intelligence (AI) systems such as ChatGPT lead us to consider whether and how more specialized systems could be used to overcome existing barriers to the legal system. Such systems could be employed in either of the two major stages of the pursuit of justice: preliminary information gathering and formal engagement with the state’s legal institutions and professionals. We focus on (...) the former and argue that developing and deploying publicly funded AI legal advisors can reduce economic and shame-based cultural barriers to the information-gathering stage of pursuing justice. (shrink)

As costs decline and technology inevitably improves, current trends suggest that artificial intelligence (AI) and a variety of "carebots" will increasingly be adopted in medical care. Medical ethicists have long expressed concerns that such technologies remove the human element from medicine, resulting in dehumanization and depersonalized care. However, we argue that where shame presents a barrier to medical care, it is sometimes ethically permissible and even desirable to deploy AI/carebots because (i) dehumanization in medicine is not always morally wrong, and (...) (ii) dehumanization can sometimes better promote and protect important medical values. Shame is often a consequence of the human-to-human element of medical care and can prevent patients from seeking treatment and from disclosing important information to their healthcare provider. Conditions and treatments that are shame-inducing offer opportunities for introducing AI/carebots in a manner that removes the human element of medicine but does so ethically. We outline numerous examples of shame-inducing interactions and how they are overcome by implementing existing and expected developments of AI/carebot technology that remove the human element from care. (shrink)

The aim of this review is to show the fruitfulness of using images of facial expressions as experimental stimuli in order to study how neural systems support biologically relevant learning as it relates to social interactions. Here we consider facial expressions as naturally conditioned stimuli which, when presented in experimental paradigms, evoke activation in amygdala–prefrontal neural circuits that serve to decipher the predictive meaning of the expressions. Facial expressions offer a relatively innocuous strategy with which to investigate these normal variations (...) in affective information processing, as well as the promise of elucidating what role the aberrance of such processing might play in emotional disorders. (shrink)

What makes a visually appealing landscape? How can the design and use of a landscape be harmonised? In this significantly revised and updated third edition of Simon Bell's seminal text, he further explores the answers to these questions by interrogating a range of design principles, applications and ideas. Written for students, instructors and professionals, the book unveils a visual design vocabulary for anyone involved with landscape aesthetics including landscape architects, architects, planners, urban designers, landscape managers, foresters, geographers and ecologists. Structured (...) around key design terms, which are explained and illustrated using an extensive range of examples from around the world, including North America, Europe and Asia, this book enables you to describe, debate and design the visual landscape. It starts with basic elements, before moving onto variable design components, and then the ways these elements are organized into compositions, in order to demonstrate how landscapes are created and how meanings and patterns are perceived within them. This new full colour edition contains over 240 images; an updated introduction; examples from China, Vietnam, and central Asia; a chapter on how to read and understand visual design elements in the landscape; a teaching model for instructors; and expanded appendix materials including a glossary, references and further reading. (shrink)

This work explores the underlying issues and problems surrounding reflection, describing a selection of initiatives and fulfilling a need for novice reflectors to increase their knowledge. The theoretical underpinnings are presented, along with the realities of using reflection in practice.

Under conditions of high social and political polarization, expressing political anger online toward systemic injustice faces an apparent trilemma: Express none but lose anger's valuable goods; express anger to heterogeneous audiences but risk aggravating inter-group polarization; or express anger to like-minded people but succumb to the epistemic pitfalls and extremist tendencies inherent to homogeneous groups. Solving the trilemma requires cultivating an online environment as a deliberative system composed of four kinds of groups—each with distinct purposes and norms. I argue that (...) applying empirically-guided design principles to this systems framework provides political anger a place where its powers can serve justice without damaging the epistemic, ethical, emotional, and community resources required for a democratic path to correcting systemic injustice. (shrink)

This case study explores the ethical complexities surrounding the treatment of Mrs. H, an elderly woman with multiple myeloma. Divergent goals between her family, rooted in Ubuntu and Christian values, and the medical team prompted ethical deliberation. Faced with this tension, the care team, guided by principles of solidarity and cultural humility, engaged in meaningful dialogue facilitated by an experienced ethicist. The resolution respects the family's cultural and religious beliefs while adhering to medical ethics. This case highlights the importance of (...) understanding and integrating cultural values in healthcare decision-making, ultimately achieving a patient-centered approach that respects the diversity of perspectives. (shrink)

Clinical ethicists must be attuned to nonverbal cues and the deeper issues they raise, and be willing and agile to change course, if needed, from discussing goals of care to establishing trust. We present a case study where a family and care team disagree about whether a lack of a do-not-resuscitate and do-not-intubate (DNR/DNI) order for a patient with a terminal prognosis is leading to medically justifiable and ethically defensible decisions. An ethicist called a family meeting to discuss the order (...) but determined, after reading the family’s nonverbal cures, that establishing trust was first needed in order to have that discussion, and that such trust could be built by not discussing the order. (shrink)

During a clinical ethics fellow’s first week of independent supervised service, two unhoused patients on the same floor were resisting the medical team’s recommendations to discharge. In the team’s view, both were medically stable and no longer required hospitalization in an acute setting. The medical team suspected malingering for both. The social worker and case manager had employed their usual means of gentle persuasion and eliminating psychosocial barriers to no avail. Rather than call the police, the attending physician, social worker, (...) and case manager decided to call ethics. These cases lead the fledgling fellow to consider the appropriate role for ethicists in difficult discharge cases. The article analyzes each case, evaluates their similarities and differences in the context of suspected malingering, and comments on ethical issues surrounding cases of suspected malingering. Finally, I reflect on the value and importance of developing and maintaining epistemic and professional independence. (shrink)

This case study discusses the challenges of end-of-life decision-making in practice, focusing on the delicate balance between medical paternalism, shared decision-making, and the rights of surrogate decision makers. The family initially struggles to grasp the severity of their loved one’s medical condition but a pivotal moment during the Goals of Care meeting brings sudden clarity. This case explores the appropriateness and implications of the practice of informed non-dissent; and our analysis suggests that it is inappropriate unless there is compelling evidence (...) for decision paralysis. Practical strategies are offered that facilitate compassionate dying care within the constraints of clinical urgency. (shrink)

The field of left–right (LR) patterning—the study of molecular mechanisms that yield directed morphological asymmetries in otherwise symmetrical organisms—is in disarray. On one hand is the undeniably elegant hypothesis that rotary beating of inclined cilia is the primary symmetry‐breaking step: they create an asymmetric extracellular flow across the embryonic midline. On the other hand lurk many early symmetry‐breaking steps that, even in some vertebrates, precede the onset of ciliary flow. We highlight an intracellular model of LR patterning where gene expression (...) is initiated by physiological asymmetries that arise from subcellular asymmetries (e.g. motor‐protein function along oriented cytoskeletal tracks). A survey of symmetry breaking in eukaryotes ranging from protists to vertebrates suggests that intracellular cytoskeletal elements are ancient and primary LR cues. Evolutionarily, quirky effectors like ciliary motion were likely added later in vertebrates. In some species (like mice), developmentally earlier cues may have been abandoned entirely. Late‐developing asymmetries pose a challenge to the intracellular model, but early mid‐plane determination in many groups increases its plausibility. Multiple experimental tests are possible. BioEssays 29: 271–287, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

Spirituality and religion are not synonymous and, in fact, require not only different definitions but also appropriate vocabulary. A deeper discussion of the issues concerning spirituality ensues in several sections: 1) fundamental differences between spirituality and religion; 2) brain operations relative to transcendent states; 3) a definition of consciousness; 4) music, culture, and transcendence; 5) transcendence; 6) transcendence through music, and 7) spirituality in music education. The last section contains several recommendations on how spirituality can be embraced by music educators (...) and included in the curriculum to enhance the worldview of students. (shrink)

In some families, there is an inseparable connection between showing love, caring, and providing food. These conceptual connections can create tension between families and care teams over end-of-life care for critically ill late-stage cachexic patients with cancer when families demand that their loved one receive feeds. This case study describes how to dissolve these tensions without compromising the family’s values or the medical team’s ethical duty of nonmaleficence.

Descartes thought that belief was a voluntary matter. His account of error in the Fourth Meditation is based on this. Given his account of what it is to have a true idea he thought that our false beliefs could be accounted for by the fact that while our intellectual capacity is limited our capacity for willing is unlimited, and so allows us to give our assent to what we do not truly perceive. Spinoza, on the other hand, thought that the (...) intellect and will cannot be separated in such a way, and urged that ‘In the mind there is no volition or affirmation and negation excepting that which the idea, in so far as it is an idea, involves’ . One philosopher, S. Hampshire, sees this distinction between Descartes and Spinoza as one of the dividing lines of philosophy . Yet it is not easy to see wherein the division lies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Music Education and Spirituality:Philosophical Exploration IiAnthony J. PalmerMusic, beyond its pitches and rhythms, timbres and dynamics, has elusive qualities that many have difficulty identifying and discussing. In this regard Rabindranath Tagore speaks of the "ineffable":But when our heart is fully awakened in love, or in other great emotions, our personality is in its flood-tide. Then it feels the longing to express itself for the very sake of expression. Then (...) comes art, and we forget the claims of necessity, the thrift of usefulness; the spires of our temples try to kiss the stars and the notes of our music to fathom the depth of the ineffable.1Abraham Maslow points to a similar state of being:Transcendence refers to the very highest and most inclusive or holistic levels of human consciousness, behaving and relating, as ends rather than as means, to oneself, to significant others, to human beings in general, to other species, to nature, and to the cosmos.2 [End Page 143]One deep, the other beyond, both direct attention toward something richer, exceeding technical competence and excellent rendition of the score. Yet, the very realms where these qualities reside seem to be above our ability to assess other than to say, "we know it when we experience it."3 Is there some realization that we have transcended the mundane, passed over to another plane of existence and gone beyond an egocentric mind-frame? And could subjective reports satisfy any objective criteria that the event truly happened? Moreover, could one's experience be distinguished qualitatively from another's? This is one of the quandaries when attempting to assess experience of such an elusive nature. Although, these questions lie at the foundation of such an inquiry as this, answers await additional investigation at a later time. For the present, this study will be limited to laying the groundwork for these future explorations.A clarification of terms preceding this essay is imperative. To begin, the discourse will use 'spirituality' and 'transcendence' interchangeably. Various readings suggest that there is sufficient agreement that these terms describe the same noumenal experience. For example, physicist Fritjof Capra states that:Spiritual experience is an experience of aliveness of mind and body as a unity. Moreover, this experience of unity transcends not only the separation of mind and body, but also the separation of self and world. The central awareness in these spiritual moments is a profound sense of oneness with all, a sense of belonging to the universe as a whole.4This essay continues in this vein and that of my previous article on the subject5 that the religious and doctrinal are not part of the discussion. Therefore, an effort will be made to distance spirituality, as used here, from religion. In that light, a brief comparison will prove helpful.Spirituality has its roots in the Latin: "in + spirare (Latin to breathe). Archaic: to breathe or blow into or upon; to infuse (as life) by breathing."6 This "blowing upon" is no better illustrated than in the account in Genesis. Chapter 2, verse 4, line 7 reads: "Then the Lord God formed man of dust from the ground, and breathed into his nostrils the breath of life; and man became a living being."7 Psyche in Greek and atman in Sanskrit have essentially the same meaning of breath and being alive, that is, embodying an animating force.This animating force, in my view, is not of metaphysical origins, but rather inherent in the evolution of the human species. Spirituality is a human quality as a product of supreme levels of consciousness. Additionally, it has the quality of knowing that we are conscious. C. G. Jung's statement is appropriate in describing this seemingly incomprehensible characteristic.Were organized religion to disappear by some quirk of social process, the human community still cannot and must not do without cultivating the spiritual, [End Page 144] what Jung calls the "attitude peculiar to a consciousness which has been changed by experience of the numinosum."8Diane Ackerman supports the non-metaphysical origins of the impulse.Our sensitivity to religion means that at some stage in human history, our chance of mating and surviving increased... (shrink)

My writing is simply a set of experiments in life—an endeavour to see what our thought and emotion may be capable of—what stores of motive, actual or hinted as possible, give promise of a better after which we may strive—what gains from past revelations and discipline we must strive to keep hold of as something more than shifting theory. I became more and more timid—with less daring to adopt any formula which does not get itself clothed for me in some (...) human figure and individual experience, and perhaps that is a sign that if I help others to see at all it must be through the medium of art. George Eliot. In his inaugural lecture, given in Birkbeck College in 1987, Roger Scruton, who has done as much as anyone else in recent years to bring the importance of art in general and literature in particular to the attention of philosophers, contends that ‘philosophy severed from literary criticism is as monstrous a thing as literary criticism severed from philosophy’. The first, he argues, aims to be science: strives after theoretical truth which it can never attain; and results in banality clothed in pseudo-scientific technicalities: while the second is liable to find consolation in the kind of nonsense which pretends that in the study of literature we are confronted with nothing other than an author-less, unreadable, ‘text’. Philosophy, he maintains, ‘must return aesthetics to the place that Kant and Hegel made for it: a place at the centre of the subject, the paradigm of philosophy and the true test of all its claims’. (shrink)

The ways in which mental concepts can seem problematic are various, and consequently the idea of a coherent body of issues forming one part of philosophy, namely the philosophy of mind, is highly misleading. When Ludwig Wittgenstein and Gilbert Ryle inaugurated the flood of recent writings about the concept of mind there was some similarity, although not identity, in the problems which led them to concentrate their attention on mental concepts. Wittgenstein saw that lack of clarity about such notions as (...) willing, thinking, feeling and imagining generated powerful but misleading pictures about logic—about the difference between sense and nonsense —so that if we were to become clear about one we should have to become clear about the other. Worries about logic generated his interest in what it is to have a mind. In the case of Ryle, if we are to accept his own autobiographical remarks, an exposition of the logic of mental concepts was undertaken to illustrate whatever clarity had already been achieved by him and others with regard to logic and logical investigations. ‘The Concept of Mind was a philosophical book written with a meta-philosophical purpose’. Although I think it should be open for speculation just why specifically mental notions were singled out by him for such an illustrative purpose. In each case questions about logic prompted writing about the mind. There remains an echo of this in some of the books under review, but, as often with deepseated changes, the original impetus can soon be lost, and debates about distinctions in which it was first embodied can take on a life of their own. (shrink)

So stellt der satz den Sachverhalt gleichsam auf eigene Faust dar. Foreword . Towards the end of this paper I refer to the work of A. J. Smith who died suddenly on 11 December 1991. His last book, Metaphysical Wit , was published in January 1992 by Cambridge University Press. I would like this paper to be thought of as a small tribute to the man and his work.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Charm and Speed: Virtuosity in the Performing ArtsAnthony J. PalmerV. A. Howard, Charm and Speed: Virtuosity in the Performing Arts (New York: Peter Lang, 2008)There may be one other book on virtuosity, but nothing that approaches the depth of argument put forth by V. A. Howard in Charm and Speed. As the author states, “[t]his book offers an interpretation, analysis, and reconstruction of the concept of virtuosity which (...) plays so prominent a role in historical, critical, and theoretical discussions of artistic performance.”1 The book is not an easy read, however, because of Howard’s customarily esoteric vocabulary. While the writing is in fine style, there are too many occasions where the reader may be hampered by having to pause to reconsider what was stated, especially in some of the longer sentences, or because a dictionary consultation is warranted.Nevertheless, this is a must-read for voice and instrumental students and their teachers, coaches, and accompanists. Moreover, this book is a must-read for anyone working with performing artists; Howard covers the performance arts broadly, including theatre and dance as well. If you only surmise what virtuosity is, you will become intimately aware of its meaning and all its ramifications.Its casual use suggests that virtuosity can be found everywhere, from auto mechanics to baristas and even include, as Howard describes, cheetahs on the hunt and the kill. And although the cheetah is perfectly suited to find food to feed her [End Page 101] cubs, the intentional development of techniques and a conscious plan to attack her prey is questionable; she acts out of instinct. We can admire various manifestations of excellence, but their qualities do not measure up to the characteristics of virtuosity. Excellence in execution is not by such virtue virtuosic.The fact is performance in the arts requires a special understanding of virtuosity that must be narrowly applied under appropriate conditions. The ten chapters comprising the book deal with every facet of virtuosity in performance and clarify the issues forcefully and accurately. Charm and Speed is a brief treatise of only 134 pages, plus notes and a 3-page appendix. But in those chapters lie explanations to which most professional performers, teachers, and subsidiary personnel may need to give serious consideration. On the other end of the spectrum, for those who may require a less than keenly argued thesis, how much does one really need to know about virtuosity to enjoy fine, but lesser, performance? Some differences do need to be noted, however, and confusing virtuosity with other artistic appellations could be eliminated.At the outset, virtuosity can easily be confused with creativity, but the latter is more general while “a judgment of virtuosity is necessarily grounded in the observables of execution.”2 Howard’s outline of the conditions of virtuosity is carried throughout the discussion. Three parts comprise any consideration: 1) the performing individual or group “inclusive of training and manifest talent,” judged by experts; 2) the domain of the performance—acting, dancing, and playing the violin—must be specified; and 3) the audience comprised of a general audience and “critics, colleagues, and institutions” must render appropriate judgment.3 Virtuosity is not a single state but requires both process and achievement.Howard narrows his discussion on virtuosity to those in the performing arts, “to those who play instruments, or sing or act, dance or conduct,”4 with no other reason or intention but to render the artwork with unique interpretations at the highest level possible. Howard restricts discourse to allographic5 works in the Western tradition, an important distinction that I had considered questionable at first, but came to realize that virtuosity considered on a wider scale could be overly complicated. My experience with Japanese performing art, for example, would have to examine, Nô, Bunraku, Kabuki theatre, and traditional vocal and instrumental performance, among other things, all quite complex in their own right. Can a puppet in Bunraku be a virtuoso, or would it be the puppeteer? Further, Korean art forms such as pansori and African arts, where some cultures are communal rather than performed by superb practitioners, would all have to be considered. When the whole world is examined... (shrink)