The application of machine learning in health care holds great promise for improving care. Indeed, our own team is collaborating with experts in machine learning and statistical modeling to bu...

The authors put forward an interesting response to detractors of black box algorithms. According to the authors, what is of ethical relevance for medical artificial intelligence is not so much their transparency, but rather their reliability as a process capable of producing accurate and trustworthy results. The implications of this view are twofold. First, it is permissible to implement a black box algorithm in clinical settings, provided the algorithm’s epistemic authority is tempered by physician expertise and consideration of patient autonomy. (...) Second, physicians are not expected to possess exhaustive knowledge or understanding of the algorithmic computation by which they verify or augment their medical opinions. The potential of these algorithms to improve diagnostic and procedural accuracy alongside the quality of patient decision-making is undoubtedly a boon to modern medicine, but blind deference to them is neither feasible nor responsible, as several logistical and ethical quagmires noted by the authors still remain inherent in algorithmic software. I concur …. (shrink)

UP. Berel Lang shows in this penetrating book how Heideggeer's own silence on the 'Jewish Question' --how (or if) the Jews were to live among the nations- ...

Rapid advancements in artificial intelligence and machine learning (AI/ML) in healthcare raise pressing questions about how much users should trust AI/ML systems, particularly for high stakes clinical decision-making. Ensuring that user trust is properly calibrated to a tool’s computational capacities and limitations has both practical and ethical implications, given that overtrust or undertrust can influence over-reliance or under-reliance on algorithmic tools, with significant implications for patient safety and health outcomes. It is, thus, important to better understand how variability in trust (...) criteria across stakeholders, settings, tools and use cases may influence approaches to using AI/ML tools in real settings. As part of a 5-year, multi-institutional Agency for Health Care Research and Quality-funded study, we identify trust criteria for a survival prediction algorithm intended to support clinical decision-making for left ventricular assist device therapy, using semistructured interviews (n=40) with patients and physicians, analysed via thematic analysis. Findings suggest that physicians and patients share similar empirical considerations for trust, which were primarilyepistemicin nature, focused on accuracy and validity of AI/ML estimates. Trust evaluations considered the nature, integrity and relevance of training data rather than the computational nature of algorithms themselves, suggesting a need to distinguish ‘source’ from ‘functional’ explainability. To a lesser extent, trust criteria were also relational (endorsement from others) and sometimes based on personal beliefs and experience. We discuss implications for promoting appropriate and responsible trust calibration for clinical decision-making use AI/ML. (shrink)

Despite the promise of new gene editing technologies (GETs) (e.g., CRISPR) in accelerating sustainable agri-food production, the social acceptability of these technologies remains unclear. Prior literature has primarily addressed the regulatory and economic issues impacting GETs ongoing acceptability, while little work has examined socio-cultural impacts despite evolving food policies and product commercialisation demanding input from various actors in the food system. Our systematic review across four databases addresses this gap by synthesising recent research on food system actors’ perspectives to identify (...) the key socio-cultural factors influencing GET acceptability. This review extends prior literature by including views from a more diverse range of actors (e.g., farmers and NGOs) and provides a better understanding of their perceived social benefits and concerns. We find food system actors perceive positive and negative impacts of using GETs in agriculture. These perspectives are often entangled in broader debates regarding sustainability and food systems issues (e.g., social justice). We discuss practical recommendations for policymakers, agri-food industry managers, and scientists to better align gene edited foods (GEFs) with food system actors’ values. GEF policy, development, and commercialisation must reflect social values such as collective wellbeing and transparency to improve actors’ acceptability. More research is required among marginalised food actors such as Indigenous and smallholder farmers. (shrink)

As sophisticated artificial intelligence software becomes more ubiquitously and more intimately integrated within domains of traditionally human endeavor, many are raising questions over how responsibility (be it moral, legal, or causal) can be understood for an AI’s actions or influence on an outcome. So called “responsibility gaps” occur whenever there exists an apparent chasm in the ordinary attribution of moral blame or responsibility when an AI automates physical or cognitive labor otherwise performed by human beings and commits an error. Healthcare (...) administration is an industry ripe for responsibility gaps produced by these kinds of AI. The moral stakes of healthcare are often life and death, and the demand for reducing clinical uncertainty while standardizing care incentivizes the development and integration of AI diagnosticians and prognosticators. In this paper, we argue that (1) responsibility gaps are generated by “black box” healthcare AI, (2) the presence of responsibility gaps (if unaddressed) creates serious moral problems, (3) a suitable solution is for relevant stakeholders to voluntarily responsibilize the gaps, taking on some moral responsibility for things they are not, strictly speaking, blameworthy for, and (4) should this solution be taken, black box healthcare AI will be permissible in the provision of healthcare. (shrink)

Nature did not equip any of its creatures with wheels, but that means of locomotion was discovered anyway; an even swifter vehicle for the mind has been found in the atom—that irreducible unit which by virtue of its ubiquity provides reason with immediate access to alien objects, naturalizes nature, and urges an essential likeness beneath appearances so diverse that only an improbable imagination would even have placed them in a single world. The goal of atomism is to find one entity, (...) a building block which then in multiples constitutes the structures of reality and appearance. All that is needed, given this once and future One, is a set of transformational rules—and everything comes to life that has been dreamed of in the topologies of geometry, physics, history, even of metaphysics: a full representation of the world as it has been, is, will be. The ideology of atomism includes the assumption that, for structures distinguishable into parts and wholes, the parts precede the whole, temporally and logically. For the atomist, all structures can be analyzed in this way; that, in fact, turns out to be his definition of structure. This premise is already evident in the building-block universe first depicted by Democritus and Leucippus; it is no less present in the heady days of twentieth-century physics . It is slightly more pliable in latter-day atomists like Claude Lévi-Strauss and Noam Chomsky and their descendent structuralists; but here, too, atomic units of linguistic or social discourse are claimed as blind first causes of the sighted and complex structures allegedly derived from them. And if the followers of even these contemporary advocates find themselves still waiting for the promises of atomism to be kept, the imaginative turns of those promises—the binary code, the rules of an innate grammar—keep old expectations alive. In contrast to this general ideological assertion, the search for artistic atoms by poetics and aesthetic theory has lagged noticeably. We can see this disparity in the characteristic resistance to fragmentation by works of art; for many writers, the will of artistic appearance to exhibit itself as a whole, to insist on an undivided surface rather than on the elements within or beneath it, is precisely what distinguishes the structures of art from others. Even where a craftsmanlike impulse breaks into the surface of artistic unity , the pieces are usually counted teleologically: they matter as contributions to an effect, retrospectively. The artist himself, it is implied, deployed them in the first place to anticipate the unified surface; we , in turn, then understand them only in terms of that whole, not—with the atomist—by conjuring a unity from the earlier accidental joining of what then become accidental parts. (shrink)

In “Revive and Refuse: Capacity, Autonomy, and Refusal of Care After Opioid Overdose”, Marshall, Derse, Weiner, and Joseph contend that patients who may appear to satisfy the standard criteria for...

In their paper, “Conversational Artificial Intelligence in Psychotherapy: A New Therapeutic Tool or Agent?” Sedlakova and Trachsel (2023) claim that therapeutic insights and therapeutic changes are...

The excellent quality and depth of the various essays make [the book] an invaluable resource....It is likely to become essential reading in its field.—CHOICE.

ILLUSTRATIONS Chapter 2 1. Roy Lichtenstein, Little Big Painting 83 2. Luis Buriuel, Viridiana (Last Supper scene) 86 3. ...

In lieu of an abstract, here is a brief excerpt of the content:Berel Lang PLOTTING PHILOSOPHY: BETWEEN THE ACTS OF PHILOSOPHICAL GENRE When Hegel wrote that philosophy's Owl of Minerva takes wing only at the falling of dusk, he did not mean that philosophy is always tardy, only that it comes late in the day. It may, however, seem both late and tardy to call attention now to the role of genres in philosophical writing, and still more beside the point (...) to assess the importance of philosophical genres to our philosophical and not only to our literary understanding. Even if we find a way past the varieties of aesthetic nominalism for which any allocation to genres is a snare and a trap— recall here Croce's declaration of"eternal war" against the obscurantism of genres1—we confront the growing skepticism of literary theory as it now disputes not only the formalism presupposed in the taxonomic distinctions of genre, but also the mimetic or representational function of discourse more generally.2 If texts as such can no longer rely on a mimetic ground, it would be impossible for the formal features ofgenre, rooted in the then archaic distinction between form and content, to represent a literary (or indeed any kind of) idea; that is, it would be impossible for them to be philosophically significant. This difficulty only intensifies, of course, for philosophical writing: philosophy, we learn, ought no longer to delude itself with hopes for success as a "mirror of nature" (in Rorty's phrase of opprobrium),3 and it would then be delusion added to delusion to believe that the genres of philosophical discourse might, at another remove, mirror an object which philosophy had mistakenly been supposed to represent in the first place. That original "representation" turns out now to represent nothing at all—and Plato's attack on the deceptions ofart thus discovers a new and finer object in philosophy itself: his indictment of art at least 190 Berel Lang191 supposed that there was something for art to be deceptive about. On this postmodernist account, then, there could be no philosophical point in plotting the course of philosophical genres; and indeed there could hardly be any other point except perhaps for antiquarians intent on finding a place for genres among the other historical curiosities which philosophers, quite inexplicably, once took seriously, like Descartes's piece of wax or Plato's aviary or Berkeley's tar water. Such intimations of the death of genres, however, may be not only premature but misdirected in rather a special way. For even in a less suspicious age, when the prima facie claims for the existence of genres might have been accepted at face value, their role was shadowy, fixed in a rhetorical limbo. Evidently (or so I would argue), there have existed generic conventions of which philosophical writers have been aware and to which their writings conformed. But even among writers in whom this pattern is most explicit and self-conscious, it is not as though the writer, after first reviewing a list of genres, would then simply choose the one among them that most recommended itself. No doubt, a writer's style—including the genre of his writing—is deliberate, in some sense a matter of choice. But the conception of "choice" in this context is an unusual one. Plotting genre could not be like trying on suits until one finds a likely fit— because this would imply that when the philosopher is trying out various possibilities, what he measures them by exists in his own mind as a philosophical Ur-genre, something which itself transcends the requirements of genre. We might suspect the presence here of the genre of all genres that is not itself, however, the member of a genre. And although it is possible that such a philosophical bedrock exists—this would be, in a way, a true philosopher's stone—all that philosophers have turned up in their history as a matter offact is a considerable number and variety of—well, we have to say it—philosophical genres. Genres, in other words, have rarely been read or written as "natural kinds," and yet they have surely been read and written. The distinctions among them and even the broad tide... (shrink)

This article analyses the slippery notions of the normal and normality in select works of Richard von Krafft-Ebing (1840–1902) and Sigmund Freud (1856–1939) and argues that homosexuality became a ‘boundary object’ between the normal and the abnormal in their works. Constructing homosexuality as ‘normal enough’ provided these two key thinkers of the fin de siècle with an opportunity to challenge societal and medical norms: Krafft-Ebing did this through mapping perversions; Freud, by challenging perceived norms about sexual development more broadly. The (...) article submits that the scientific logic presented in Krafft-Ebing’s seminal case study compilation Psychopathia Sexualis and Freud’s early theoretical writings and cases, including Three Essays on the Theory of Sexuality (1905), was itself haunted by notions of norms and the normal that were not always easy to resolve, and sometimes involved a certain amount of inspired conjecture on the part of both thinkers in order to develop and validate their differing tripartite models of normality. Krafft-Ebing imagined homosexuality as a variation of the normal by generalizing a gay male experience. He also recorded the obstreperous cases of homosexual women based largely inside the clinic but by and large ignored this evidence. Freud inextricably bound homosexuality to normality (and vice versa) by redefining homosexuals as a group to include individuals with unconscious same-sex desire. Doing so allowed him to conceptualize the fear of homosexuality as crucial in the formation of neurosis and psychosis, and at the same time put him at odds with relevant early identity politics. (shrink)

ABSTRACT:Bioethicists today are taking a greater role in the design and implementation of emerging technologies by "embedding" within the development teams and providing their direct guidance and recommendations. Ideally, these collaborations allow ethical considerations to be addressed in an active, iterative, and ongoing process through regular exchanges between ethicists and members of the technological development team. This article discusses a challenge to this embedded ethics approach—namely, that bioethical guidance, even if embraced by the development team in theory, is not easily (...) actionable in situ. Many of the ethical problems at issue in emerging technologies are associated with preexisting structural, socioeconomic, and political factors, making compliance with ethical recommendations sometimes less a matter of choice and more a matter of feasibility. Moreover, incentive structures within these systemic factors maintain them against reform efforts. The authors recommend that embedded bioethicists utilize principles from behavioral science (such as behavioral economics) to better understand and account for these incentive structures so as to encourage the ethically responsible uptake of technological innovations. (shrink)

In their article, ‘Responsibility, Second Opinions, and Peer-Disagreement—Ethical and Epistemological Challenges of Using AI in Clinical Diagnostic Contexts,’ Kempt and Nagel argue for a ‘rule of disagreement’ for the integration of diagnostic AI in healthcare contexts. The type of AI in question is a ‘decision support system’, the purpose of which is to augment human judgement and decision-making in the clinical context by automating or supplementing parts of the cognitive labor. Under the authors’ proposal, artificial decision support systems which produce (...) automated diagnoses should serve chiefly as confirmatory tools; so long as the physician and AI agree, the matter is settled, and the physician’s initial judgement is considered epistemically justified. If, however, the AI-DSS and physician disagree, then a second physician’s opinion is called on to resolve the dispute. While the cognitive labour of the decision is shared between the physicians and AI, the final decision remains at the discretion of the first physician, and with it the moral and legal culpability. The putative benefits of this approach are twofold: healthcare administration can improve diagnostic performance by introducing AI-DSS without the unintended byproduct of a responsibility gap, and assuming the physician and AI disagree less than the general rate of requested second opinions, and the AI’s diagnostic accuracy supersedes or at least …. (shrink)

Les informaticiens, qui sont les premiers à avoir travaillé à la conception du libre accès, ne s’en sont pas nécessairement saisis pour leurs propres pratiques de publication scientifique, privilégiant longtemps les échanges interindividuels. La question de l’accès ouvert se pose pour leurs productions de manière différente selon qu’il s’agit de conception de logiciels ou de publication de texte, de recherche industrielle ou publique, de secteurs brevetables, de données ouvertes ou non.Computer scientists, who were the first to work on open access (...) design, have not necessarily been its most fervent users in their own scientific publication practice, since they have long given preference to interpersonal exchanges. Concerning their output, the question of open access arises in different terms, depending on whether the context is software design, text publishing, industrial public research, patentable sectors, or open or restricted access data. (shrink)