Rawls famously argues that the parties in the original position would agree upon the two principles of justice. Among other things, these principles guarantee equal political liberty—that is, democracy—as a requirement of justice. We argue on the contrary that the parties have reason to reject this requirement. As we show, by Rawls’ own lights, the parties would be greatly concerned to mitigate existential risk. But it is doubtful whether democracy always minimizes such risk. Indeed, no one currently knows which political (...) systems would. Consequently, the parties—and we ourselves—have reason to reject democracy as a requirement of justice in favor of political experimentalism, a general approach to political justice which rules in at least some non-democratic political systems which might minimize existential risk. (shrink)

Background The ethical governance of Artificial Intelligence (AI) in health care and public health continues to be an urgent issue for attention in policy, research, and practice. In this paper we report on central themes related to challenges and strategies for promoting ethics in research involving AI in global health, arising from the Global Forum on Bioethics in Research (GFBR), held in Cape Town, South Africa in November 2022. Methods The GFBR is an annual meeting organized by the World Health (...) Organization and supported by the Wellcome Trust, the US National Institutes of Health, the UK Medical Research Council (MRC) and the South African MRC. The forum aims to bring together ethicists, researchers, policymakers, research ethics committee members and other actors to engage with challenges and opportunities specifically related to research ethics. In 2022 the focus of the GFBR was “Ethics of AI in Global Health Research”. The forum consisted of 6 case study presentations, 16 governance presentations, and a series of small group and large group discussions. A total of 87 participants attended the forum from 31 countries around the world, representing disciplines of bioethics, AI, health policy, health professional practice, research funding, and bioinformatics. In this paper, we highlight central insights arising from GFBR 2022. Results We describe the significance of four thematic insights arising from the forum: (1) Appropriateness of building AI, (2) Transferability of AI systems, (3) Accountability for AI decision-making and outcomes, and (4) Individual consent. We then describe eight recommendations for governance leaders to enhance the ethical governance of AI in global health research, addressing issues such as AI impact assessments, environmental values, and fair partnerships. Conclusions The 2022 Global Forum on Bioethics in Research illustrated several innovations in ethical governance of AI for global health research, as well as several areas in need of urgent attention internationally. This summary is intended to inform international and domestic efforts to strengthen research ethics and support the evolution of governance leadership to meet the demands of AI in global health research. (shrink)

In early 2017, Nevada amended its Uniform Determination of Death Act, in order to clarify the neurologic criteria for the determination of death. The amendments stipulate that a determination of death is a clinical decision that does not require familial consent and that the appropriate standard for determining neurologic death is the American Academy of Neurology’s guidelines. Once a physician makes such a determination of death, the Nevada amendments require the withdrawal of life-sustaining treatment within twenty-four hours with limited exceptions. (...) Neurologists have generally supported Nevada’s amendments for clarifying the diagnostic standard and limiting the ability of family members to challenge it. However, it is more appropriate to view the Nevada amendments with concern. Even though the primary purpose of the UDDA is to ensure that all functions of a person’s entire brain have ceased, the AAN guidelines do not accurately assess this. In addition, by characterizing the determination of death as solely a clinical decision, the Nevada legislature has improperly ignored the doctrine of informed consent, as well as the beliefs of particular faiths and cultures that reject brain death. Rather than resolving controversies regarding brain death determinations, the Nevada amendments may instead instigate numerous constitutional challenges. (shrink)

The Specter of Capital provides a searching historical analysis and critique of the role of classical and neoclassical economic theory in creating the economic conditions which produced the global financial crisis.

The controversy over the equivalence of continuous sedation until death (CSD) and physician-assisted suicide/euthanasia (PAS/E) provides an opportunity to focus on a significant extended use of CSD. This extension, suggested by the equivalence of PAS/E and CSD, is designed to promote additional patient autonomy at the end-of-life. Samuel LiPuma, in his article, “Continuous Sedation Until Death as Physician-Assisted Suicide/Euthanasia: A Conceptual Analysis” claims equivalence between CSD and death; his paper is seminal in the equivalency debate. Critics contend that sedation follows (...) proportionality protocols for which LiPuma’s thesis does not adequately account. Furthermore, sedation may not eliminate consciousness, and as such LiPuma’s contention that CSD is equivalent to neocortical death is suspect. We not only defend the equivalence thesis, but also expand it to include additional moral considerations. First, we explain the equivalence thesis. This is followed by a defense of the thesis against five criticisms. The third section critiques the current use of CSD. Finally, we offer two proposals that, if adopted, would broaden the use of PAS/E and CSD and thereby expand options at the end-of-life. (shrink)

As human beings age, they become weak, fragile, and feeble. It is a slowly progressing yet complex syndrome in which old age or some disabilities are not prerequisites; neither does loss of human parts lead to frailty among the physically fit older persons. This paper aims to describe the influences of transhumanist perspectives on human‐technology enhancements and replacements in the transcendence of human frailties, including those of older persons, in which technology is projected to deliver solutions toward transcending these frailties. (...) Through technologies including genetic screening and other technological manipulations, intelligent machines and augmented humans improve, maintain, and remedy human‐linked susceptibilities. Furthermore, other technologies replace parts fabricated through inorganic‐mechanical processes such as 3D‐printing. Advancing technologies are reaching the summit of technological sophistication contributing to the transhumanist views of being human in a technological world. Technologies enhance the transcendence of human frailties as essential expressions of the symbiosis between human beings and technology in a transcendental world. (shrink)

Growing concern has been expressed that we have entered a “post-truth” era in which each of us willfully believes whatever we choose, aided and abetted by alternative and social media that spin alternative realities for boutique consumption. A prime example of the belief in alternative realities is said to be acceptance of “conspiracy theories”—a term that is often used as a pejorative to indict claims of conspiracy that are so obviously absurd that only the unhinged could believe them. The epistemological (...) standard often involved in this indictment, however—the standard of “obvious” falsity—invites subjectivity in its application, because what is obviously false to one person can be common sense to another. This is not just a truism; considerable research suggests that people’s political beliefs, in general, and their acceptance or rejection of conspiracy theories in particular, tends in large part to be determined by partisan, ideological, and other priors. (shrink)

The concept of ‘the violence inherent in the system’ was famously satirized by Monty Python in their movie The Holy Grail. In order to avoid ridicule, left-wing theorists and activists for a long time stopped using the expression. The underlying social critique, which had given rise to the expression, was also widely dismissed from serious consideration, merely through invocation of the phrase. Because of this, there has been little explicit discussion of the actual political theory that was being satirized in (...) this scene. And yet the theory has continued to exercise considerable influence on the practice of many left-wing groups, particularly in the way that protest is conceptualized and carried out. The central objective in this paper will be to provide an explicit articulation of the theory, in order to show how it falls short of providing a meaningful critique of any aspect of our social practices. (shrink)

In two studies, we tested how the expression of civic hope in narratives and the perceived authenticity of civic/political actions relate to civic/political engagement. In a cross-sectional study of undergraduates (N = 230), the expression of civic hope predicted the perceived authenticity of civic actions (e.g., voting), which in turn predicted the motivation to engage in them. In a longitudinal on-line study that began 8 weeks prior to the 2020 U.S. Presidential election (N = 308 MTurk workers), overall expressions of (...) civic hope positively predicted the perceived authenticity of voting and the motivation to vote. In addition, expressions of civic hope positively predicted the perceived authenticity of voting, which in turn positively predicted the likelihood of reporting that one did vote. These findings indicate that a sense of civic hope and the experience of authenticity in political contexts may be important for democratic engagement. (shrink)

The number of clinical trials for experimental brain implants continues to grow, and with this growth comes an increased reliance upon patients with treatment-refractory conditions to volunteer as...

When intense public controversy erupted around agricultural biotechnology in the late 1990s, critics found opportunities to challenge risk assessment criteria and test methods for genetically modified products. In relation to GM food, they criticized the concept of substantial equivalence, which European Union and United States regulators had adopted as the basis for a harmonized, science-based approach to risk assessment. Competing policy agendas framed scientific uncertainty in different ways. Substantial equivalence was contested and eventually recast to accommodate some criticisms. To explain (...) how the concept changed, this article links two analytical perspectives. Regulatory-science perspectives illuminate how the scientification of politics and politicization of science led to shifts in the boundary between science and policy. Governance perspectives illuminate how the collective problem for policy was redefined to provide a new common ground for some stakeholders. Overall, substantial equivalence was recast to govern the social conflict and address legitimacy problems of regulatory procedures. (shrink)

Recent global events demonstrate that analytical frameworks to aid professionals in healthcare ethics must consider the pervasive role of social structures in the emergence of bioethical issues. To address this, the authors propose a new sociologically informed approach to healthcare ethics that they term “social bioethics.” Their approach is animated by the interpretive social sciences to highlight how social structures operate vis-à-vis the everyday practices and moral reasoning of individuals, a phenomenon known as social discourse. As an exemplar, the authors (...) use social bioethics to reframe common ethical issues in psychiatric services and discuss potential implications. Lastly, the authors discuss how social bioethics illuminates the ways healthcare ethics consultants in both policy and clinical decision-making participate in and shape broader social, political, and economic systems, which then cyclically informs the design and delivery of healthcare. (shrink)

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

In this book Joseph Heath brings Jürgen Habermas's theory of communicative action into dialogue with the most sophisticated articulation of the instrumental conception of practical rationality-modern rational choice theory. Heath begins with an overview of Habermas's action theory and his critique of decision and game theory. He then offers an alternative to Habermas's use of speech act theory to explain social order and outlines a multidimensional theory of rational action that includes norm-governed action as a specific type.In the second (...) part of the book Heath discusses the more philosophical dimension of Habermas's conception of practical rationality. He criticizes Habermas's attempt to introduce a universalization principle governing moral discourse, as well as his criteria for distinguishing between moral and ethical problems. Heath offers an alternative account of the level of convergence exhibited by moral argumentation, drawing on game-theoretic models to specify the burden of proof that the theory of communicative action and discourse must assume. (shrink)

Matteo Ricci (1552-1610) was an Italian Jesuit and one of the first Christian missionaries to China in the modern era. He was a genuine polymath—a translator, cartographer, mathematician, astronomer, and musician. Above all, Ricci was a missionary for the gospel. As we briefly examine his 1603 seminal work, The True Meaning of the Lord of Heaven, our hope is that we, as evangelical educators, will perceive some of the deeper principles necessary for our own missionary work among unreached people.

It does not derive its authority, as many authors have supposed, from some logically prior discipline, whether physics, economics, or philosophy, these ultimately depend on law itself, in its fundamental expression of human intellect and purpose. Law, he holds, is inseparably connected to everything in the world that goes to make up personal identity and meaning.

It is commonly thought that disability is a harm or “bad difference” because having a disability restricts valuable options in life. In his recent essay “Disability, Options and Well-Being,” Thomas Crawley offers a novel defense of this style of reasoning and argues that we and like-minded critics of this brand of argument are guilty of an inconsistency. Our aim in this article is to explain why our view avoids inconsistency, to challenge Crawley's positive defense of the Options Argument, and to (...) suggest that this general line of reasoning employs a double standard. (shrink)

ABSTRACT:U.S. Organizational Sentencing Guidelines provide firms with incentives to develop formal ethics programs to promote ethical organizational cultures and thereby decrease corporate offenses. Yet critics argue such programs are cosmetic. Here we studied bank employees before and after the introduction of formal ethics training—an important component of formal ethics programs—to examine the effects of training on ethical organizational culture. Two years after a single training session, we find sustained, positive effects on indicators of an ethical organizational culture (observed unethical behavior, (...) intentions to behave ethically, perceptions of organizational efficacy in managing ethics, and the firm’s normative structure). While espoused organizational values also rose in importance post-training, the boost dissipated after the second year which suggests perceptions of values are not driving sustained behavioral improvements. This finding conflicts with past theory which asserts that enduring behavioral improvements arise from the inculcation of organizational values. Implications for future research are discussed. (shrink)

We introduce a homotopy-theoretic interpretation of intuitionistic first-order logic based on ideas from Homotopy Type Theory. We provide a categorical formulation of this interpretation using the framework of Grothendieck fibrations. We then use this formulation to prove the central property of this interpretation, namely homotopy invariance. To do this, we use the result from [8] that any Grothendieck fibration of the kind being considered can automatically be upgraded to a two-dimensional fibration, after which the invariance property is reduced to an (...) abstract theorem concerning pseudonatural transformations of morphisms into two-dimensional fibrations. (shrink)

The Erasmus Journal for Philosophy and Economics interviewed Vogl about his intellectual career, his relationship to the history and philosophy of economics, and his perspective on the analysis of contemporary capitalism.

Volume 20, Issue 3, March 2020, Page 44-46.

Virtues can be considered to play a causal role in the production of behaviour and so too can our self-narratives. We identify a point of connection between the two cases and draw a parallel between them. But, those folk psychological notions, virtues and self-narratives, fail to reduce smoothly to the underlying human physiology. As a first step towards handling that failure to connect with the scientific framework that is the familiar grounding for our understanding of causation, we consider the causal (...) theory of action, a leading theory of action, which shows how reasons, understood as an appropriate pair of beliefs and desires, can be treated as causes of action. Davidson’s picture is based on cause as a relation between events, which can have both a description in scientific terms and in folk psychological terms. The character of both virtues and self-narratives is not that of events, even extended ones, so we need to refer to examples of scientific explanation that incorporate structural properties of objects. While we retain the spirit of the causal theory, we wish to guard against any unwarranted optimism that an explicitly scientific explanation for human action lies in our future, drawing on Chomsky’s view that a causal explanation of human actions is likely to remain beyond human science forming capacities. We take a mild-realist view of virtues and self-narratives, in the style of Dennett. We argue that, in spite of that limited form of realism, underlined by Chomsky’s mysterian position in this domain, we still need to frame our explanations of behaviour based on virtues and self-narratives in causal terms. (shrink)

This paper develops some modal metatheory for quantified modal logic. In such a theory, the logic of a first-order modal object-language is made sensitive to the modal facts, stated in the metalanguage. This is radically different from possible worlds semantics, which reduces questions of validity to questions of nonmodal set theory. We consider theories which characterize a notion of truth under a second-order interpretation, where an operator for metaphysical necessity is treated homophonically. The form they take is crucially influenced by (...) whether the Barcan formulas are part of the metalogic. The main result is that, with the Barcan formulas, formulating a modal metatheory is easy; principles of classical semantics transfer over smoothly with natural adaptations to the modal setting. Without the Barcan formulas, it seems to be much harder. Several options are considered, but each involves commitments plausibly in tension with the underlying philosophical motivations for rejecting them. (shrink)

In the longstanding foundational debate whether to require that probability is countably additive, in addition to being finitely additive, those who resist the added condition raise two concerns that we take up in this paper. (1) _Existence_: Settings where no countably additive probability exists though finitely additive probabilities do. (2) _Complete Additivity_: Where reasons for countable additivity don’t stop there. Those reasons entail complete additivity—the (measurable) union of probability 0 sets has probability 0, regardless the cardinality of that union. Then (...) probability distributions are discrete, not continuous. We use Easwaran’s (Easwaran, Thought 2:53–61, 2013) advocacy of the _Comparative_ principle to illustrate these two concerns. Easwaran supports countable additivity, both for numerical probabilities and for finer, qualitative probabilities, by defending a condition he calls the _Comparative_ principle [ \({\mathcal{C}}\) ]. For numerical probabilities, principle \({\mathcal{C}}\) contrasts pairs, P 1 and P 2, defined over a common partition \(\prod\) = {a _i_ : _i_ ∈ I} of measurable events. \({\mathcal{C}}\) requires that no P 1 may be pointwise dominated, i.e., no (finitely additive) probability P 2 exists such that for each _i_ ∈ I, P 2 (a _i_ ) > P 1 (a _i_ ). By design, the cardinality of \(\prod\) is not limited in \({\mathcal{C}}\), which Easwaran asserts is important when arguing that the principle does not require more, or less, than that probability is countably additive. We agree that a numerical probability P satisfies principle \({\mathcal{C}}\) in all partitions just in case P is countably additive. However, we show that for numerical probabilities, by considering the size of the algebra of events to which probability is applied, principle \({\mathcal{C}}\) is subject to each of the above concerns, (1) and (2). Also, Easwaran considers principle \({\mathcal{C}}\) with non-numerical, qualitative probabilities, where a qualitative probability may be finer than an almost agreeing numerical probability P. A qualitative probability is regular if possible events are strictly more likely than impossible events. Easwaran motivates and illustrates regular qualitative probabilities using a continuous, almost agreeing quantitative probability that is uniform on the unit interval. We make explicit the conditions for applying principle \({\mathcal{C}}\) with qualitative probabilities and show that \({\mathcal{C}}\) restricts regular qualitative probabilities to those whose almost agreeing quantitative probabilities are completely additive. For instance, Easwaran’s motivating example of a regular qualitative probability is precluded by principle \({\mathcal{C}}\). (shrink)

Evolving practice requires peer review of clinical ethics (CE) consultation for quality assessment and improvement. Many institutions have identified the chart note as the basis for this process, but to our knowledge, electronic health record (EHR) systems are not necessarily designed to easily include CE consultation notes. This article provides a framework for the inclusion of CE consultation notes into the formal EHR, describing a developed system in the Epic EHR that allows for the elaborated electronic notation of the CE (...) chart note. The implementation of the “meaningful use” criteria for EHR, mandated by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, requires that health professionals meet certain standards for quality, efficiency, and safety, all of which overlap with the goals of standardization, peer review, and quality improvement within CE consultation. (shrink)

What does Wittgenstein say about the learning child? In the Philosophical Investigations, he writes, ‘An important part … will consist in the teacher’s pointing to the objects, directing the child’s attention to them, and at the same time uttering a word.’ Here Wittgenstein is describing what is called ‘joint attention’ which is agreed to be a rich resource for learning in children. In this essay, I explore the developmental significance of this passage particularly with regards the learning that occurs in (...) the pre-linguistic child during joint attention. I refer to critical remarks elsewhere in the PI which can help further convey what Wittgenstein means when he talks about attentional capacities and how they develop, including the relevant ability for responsiveness required for the learning to proceed. These considerations should motivate a defence of the social initiation model of learning contra Luntley’s mentalist-individualist account, this despite conceding that certain prior capacities do play a role, though not a central one since these do not pick out the relevant ability (responsiveness) required for learning to take place in the child. (shrink)