Experts in medical informatics have argued for the incorporation of ever more machine-learning algorithms into medical care. As artificial intelligence research advances, such technologies raise the possibility of an “iDoctor,” a machine theoretically capable of replacing the judgment of primary care physicians. In this article, I draw on Martin Heidegger’s critique of technology to show how an algorithmic approach to medicine distorts the physician–patient relationship. Among other problems, AI cannot adapt guidelines according to the individual patient’s needs. In response to (...) the objection that AI could develop this capacity, I use Hubert Dreyfus’s analysis of AI to argue that attention to the needs of each patient requires the physician to attune his or her perception to the patient’s history and physical exam, an ability that seems uniquely human. Human physician judgment will remain better suited to the practice of primary care despite anticipated advances in AI technology. (shrink)

Pellegrino and Thomasma have proposed a normative medical ethics founded on a conception of the end of medicine detached from any broader notion of the telos of human life. In this essay, I question whether such a narrow teleological account of medicine can be sustained, taking as a starting point Pellegrino and Thomasma’s own contention that the end of medicine projects itself onto the intermediate acts that aim at that end. In order to show how the final end of human (...) life similarly alters intermediate ends, such as the end of medicine, I describe Thomas Aquinas’s concept of pain and explain how his remedies for pain derive from his account of the telos of human life. In turn, this account has implications for the way in which physicians who accept such a telos would manage their patients’ pain. If a comprehensive telos for human life is necessary to make sense of even such a routine aspect of medical care, then medical ethicists may not be able to sidestep questions about the good life for human beings. (shrink)

Whereas bioethicists generally consider medicine a practice aimed at the individual good of each patient, in this paper I present an alternative conception of the goods of medicine. I first explain how modern liberal political theory gives rise to the predominant view of the medical good and then contrast this understanding of politics with that of Thomas Aquinas, informed by Aristotle. I then show how this Christian politics is implicit in certain aspects of contemporary medical practice and argue that Christians (...) ought to draw more attention to this point in order to direct medicine toward the common good. (shrink)

The greatest rhetorical challenge to developers of creative artificial intelligence systems is convincingly arguing that their software is more than just an extension of their own creativity. This paper suggests that “creative autonomy,” which exists when a system not only evaluates creations on its own, but also changes its standards without explicit direction, is a necessary condition for making this argument. Rather than requiring that the system be hermetically sealed to avoid perceptions of human influence, developing creative autonomy is argued (...) to be more plausible if the system is intimately embedded in a broader society of other creators and critics. Ideas are presented for constructing systems that might be able to achieve creative autonomy. (shrink)

From the late eighteenth through the end of the nineteenth century, educational philosophers and practitioners debated the benefits and shortcomings of the use of emulation in schools. During this period, “emulation” referred to a pedagogy that leveraged comparisons between students as a tool to motivate them to higher achievement. Many educationists praised emulation as a necessary and effective motivator. Other educationists condemned it for its tendency to foster invidious competition between students and to devalue learning. Ultimately, by the late nineteenth (...) century emulation as a specific pedagogical practice had disappeared in American educational culture. In this article, Mark Jonas and Drew Chambers ask whether the disappearance of emulation is something to be celebrated or lamented. To answer this question they examine the historical concept of educational emulation and analyze the bases on which proponents and opponents argued. Parties on both sides of the debate framed their arguments in close relation to the way emulation was being used at that time, which prioritized actual competitions and prizes. In that context, the opponents made a better case, which presumably contributed to emulation's disappearance in schools afterwards. However, as earlier proponents of emulation argued, emulation need not be restricted to competitions and prizes. Instead, these proponents offered a philosophically and psychologically rich defense of emulation, but these were not carried through to an appropriate degree. The authors conclude that, construed appropriately, emulation not only had tremendous educational potential then, but still does today. With intentional effort on the part of teachers, emulation can greatly enrich students' lives and act as a powerful learning motivator. (shrink)

Although many people choose to sign consent forms and participate in research, how many thoroughly read a consent form before signing it? Across 3 experiments using 348 undergraduate student participants, we examined whether personality characteristics as well as consent form content, format, and delivery method were related to thorough reading. Students repeatedly failed to read the consent forms, although small effects were found favoring electronic delivery methods and traditional format forms. Potential explanations are discussed and include participant apathy, participants trying (...) to save time by not reading the consent form, and participant assumptions about consent forms. (shrink)

Although the technology for telemedicine existed before the Covid‐19 pandemic, the need to provide medical services while minimizing the risk of contagion has encouraged its more widespread use. I argue that, although telemedicine can be useful in certain situations, physicians should not consider it an adequate substitute for the office visit. I first provide a narrative account of the experience of telemedicine. I then draw on philosophical critiques of technology to examine how telemedicine has epistemic and ethical effects that make (...) some of the goods of medicine unavailable. Telemedicine rules out an embodied encounter between physician and patient, in which the sense of touch has special importance. The individualized attention facilitated by the in‐person visit may better sustain a caring physician‐patient relationship. Physicians should criticize attempts by administrators, insurers, or other parties to incentivize the wholesale replacement of traditional office visits with telemedicine. (shrink)

Experts in medical informatics have argued for the incorporation of ever more machine-learning algorithms into medical care. As artificial intelligence research advances, such technologies raise the possibility of an “iDoctor,” a machine theoretically capable of replacing the judgment of primary care physicians. In this article, I draw on Martin Heidegger’s critique of technology to show how an algorithmic approach to medicine distorts the physician–patient relationship. Among other problems, AI cannot adapt guidelines according to the individual patient’s needs. In response to (...) the objection that AI could develop this capacity, I use Hubert Dreyfus’s analysis of AI to argue that attention to the needs of each patient requires the physician to attune his or her perception to the patient’s history and physical exam, an ability that seems uniquely human. Human physician judgment will remain better suited to the practice of primary care despite anticipated advances in AI technology. (shrink)

Pellegrino and Thomasma have proposed a normative medical ethics founded on a conception of the end of medicine detached from any broader notion of the telos of human life. In this essay, I question whether such a narrow teleological account of medicine can be sustained, taking as a starting point Pellegrino and Thomasma’s own contention that the end of medicine projects itself onto the intermediate acts that aim at that end. In order to show how the final end of human (...) life similarly alters intermediate ends, such as the end of medicine, I describe Thomas Aquinas’s concept of pain and explain how his remedies for pain derive from his account of the telos of human life. In turn, this account has implications for the way in which physicians who accept such a telos would manage their patients’ pain. If a comprehensive telos for human life is necessary to make sense of even such a routine aspect of medical care, then medical ethicists may not be able to sidestep questions about the good life for human beings. (shrink)

Margaret Brazier has argued that, in the literature on reproductive technology, women's “right” to reproduce is privileged, pushed, and subordinated to patriarchal values in such a way that it amounts to women's old “duty” to reproduce, dressed up in modern guise. I agree that there are patriarchal assumptions made in discussions of whether women have a right to select which embryos to implant or which fetuses to carry to term. Forcing ourselves to see women as active, rational decisionmakers tends to (...) counteract any lingering patriarchal assumptions. But rational decisionmaking requires information. Voting wisely requires information about the candidates. Taking women's reproductive rights seriously means taking seriously women's need for relevant information to make rational decisions, including decisions about which embryos to implant or alter. I argue that preimplantation genetic profiles and prenatal test information should be made available to prospective parents, especially prospective mothers, unless doing so threatens to harm the resulting child or the larger society in specifiable and important ways. (shrink)

Professionals in environmental fields engage with complex problems that involve stakeholders with different values, different forms of knowledge, and contentious decisions. There is increasing recognition of the need to train graduate students in interdisciplinary environmental science programs in these issues, which we refer to as “social ethics.” A literature review revealed topics and skills that should be included in such training, as well as potential challenges and barriers. From this review, we developed an online survey, which we administered to faculty (...) from 81 United States colleges and universities offering IESPs. Respondents overwhelmingly agreed that IESPs should address values in applying science to policy and management decisions. They also agreed that programs should engage students with issues related to norms of scientific practice. Agreement was slightly less strong that IESPs should train students in skills related to managing value conflicts among different stakeholders. The primary challenges to incorporating social ethics into the curriculum were related to the lack of materials and expertise for delivery, though challenges such as ethics being marginalized in relation to environmental science content were also prominent. Challenges related to students’ interest in ethics were considered less problematic. Respondents believed that social ethics are most effectively delivered when incorporated into existing courses, and they preferred case studies or problem-based learning for delivery. Student competence is generally not assessed, and respondents recognized a need for both curricular materials and assessment tools. (shrink)

Childress et al. (2023) argue in favor of “ECMO-DT,” the provision of ECMO indefinitely as “destination therapy” in the ICU for patients who are dependent on the technology to sustain their lives....

The field of deliberative democracy now generally recognizes the co-dependence of deliberation and voting. The field tends to emphasize what deliberation accomplishes for vote-based decisions. In this paper, we reverse this now common view to ask: In what ways does voting benefit deliberation? We discuss seven ways voting can complement and sometimes enhance deliberation. First, voting furnishes deliberation with a feasible and fair closure mechanism. Second, the power to vote implies equal recognition and status, both morally and strategically, which is (...) a condition of democratic deliberation. Third, voting politicizes deliberation by injecting the strategic features of politics into deliberation—effectively internalizing conflict into deliberative processes, without which they can become detached from their political environments. Fourth, anticipation of voting may induce authenticity by revealing preferences, as what one says will count. Fifth, voting preserves expressions of dissent, helping to push back against socially induced pressures for consensus. Sixth, voting defines the issues, such that deliberation is focused, and thus more likely to be effective. And, seventh, within contexts where votes are public—as in representative contexts, voting can induce accountability, particularly for one’s claims. We then use these points to discuss four general types of institutions—general elections, legislatures, minipublics, and minipublics embedded in referendum processes—that combine talking and voting, with the aim of identifying designs that do a better or worse job of capitalizing upon the strengths of each. (shrink)

Professionals in environmental fields engage with complex problems that involve stakeholders with different values, different forms of knowledge, and contentious decisions. There is increasing recognition of the need to train graduate students in interdisciplinary environmental science programs in these issues, which we refer to as “social ethics.” A literature review revealed topics and skills that should be included in such training, as well as potential challenges and barriers. From this review, we developed an online survey, which we administered to faculty (...) from 81 United States colleges and universities offering IESPs. Respondents overwhelmingly agreed that IESPs should address values in applying science to policy and management decisions. They also agreed that programs should engage students with issues related to norms of scientific practice. Agreement was slightly less strong that IESPs should train students in skills related to managing value conflicts among different stakeholders. The primary challenges to incorporating social ethics into the curriculum were related to the lack of materials and expertise for delivery, though challenges such as ethics being marginalized in relation to environmental science content were also prominent. Challenges related to students’ interest in ethics were considered less problematic. Respondents believed that social ethics are most effectively delivered when incorporated into existing courses, and they preferred case studies or problem-based learning for delivery. Student competence is generally not assessed, and respondents recognized a need for both curricular materials and assessment tools. (shrink)

Carson Strong argues, in that if cloning of humans by somatic cell nuclear transfer were to become a safe procedure, then infertile couples should have access to it as a last resort. He lists six reasons such couples might desire genetically related children. Of these, two are relevant to justifying their access to cloning—namely, that they want to jointly participate in the creation of a person, and that having a genetically related child would constitute an affirmation of their mutual love. (...) According to Strong, these reasons justify at least some infertile couples' freedom to clone themselves. He wants to prevent the widespread use of cloning technology by making it available to only infertile couples and only as a last resort. One way to enforce this restriction, he suggests, is to penalize physicians who carry out disallowed clonings. After all, fertile couples and many infertile couples can satisfy their need to have genetically related children in other ways. (shrink)

Supporting students to develop transferable skills and gain employment is a vital function of Universities in the era of the Fourth Industrial Revolution. A key area is work readiness, which has steadily grown in importance over the last 2 decades as tertiary institutions increasingly aim to produce graduates who perceive and are perceived as work ready. However, a large majority of graduates report a lack of skills and confidence needed for the effective transition from study to work. This may be (...) particularly problematic for disciplines that impart both discipline-specific and transferrable skills, such as psychology. The aim of this paper is to addresses the concept of work readiness within Australian psychological training and explores the need to shed light on and integrate work readiness within the pedagogy of psychology within Australia. Specifically, this paper calls for a review of work readiness skills developed in psychological courses to ensure industry needs are met. Beyond such a review, it is suggested that tertiary centres need to facilitate students in capturing and reflecting upon the transferable skills that they develop; and build assessments that allow students to demonstrate transferable skills in a meaningful way. Further, this paper proposes that work readiness skills be routinely mapped onto graduate attributes and course learning outcomes to be readily available by students so as to increase students’ potential to articulate their learnt work readiness skills once in the workplace. (shrink)

Carson Strong argues, in that if cloning of humans by somatic cell nuclear transfer were to become a safe procedure, then infertile couples should have access to it as a last resort. He lists six reasons such couples might desire genetically related children. Of these, two are relevant to justifying their access to cloning—namely, that they want to jointly participate in the creation of a person, and that having a genetically related child would constitute an affirmation of their mutual love. (...) According to Strong, these reasons justify at least some infertile couples' freedom to clone themselves. He wants to prevent the widespread use of cloning technology by making it available to only infertile couples and only as a last resort. One way to enforce this restriction, he suggests, is to penalize physicians who carry out disallowed clonings. After all, fertile couples and many infertile couples can satisfy their need to have genetically related children in other ways. (shrink)

Taste sensitivity and liking drive food choices and ingestive behaviors from childhood to adulthood, yet their longitudinal association with dietary intake and BMI is largely understudied. Here, we examined the longitudinal relationship between sugar and fat sensitivity, sugar and fat liking, habitual dietary intake, and BMI percentiles in a sample of 105 healthy-weight adolescents over a 4-year period. Taste sensitivity was assessed via a triangle fat and sweet taste discrimination test. Taste liking were rated on a visual analog scale for (...) four milkshakes that varied in sugar and fat contents, low-fat/high-sugar, high-fat/low-sugar, low-fat/low-sugar milkshakes). A modified version of the reduced Block Food Frequency Questionnaire was used to assess dietary intake. All measurements were repeated annually. Repeated measures correlations and linear mixed effects models were used to model the associations between the variables. Sugar sensitivity was negatively associated with liking for the LF/HS milkshake over the 4-year period. Low sugar sensitivity at baseline predicted increases in BMI percentile over time, but this association didn’t survive a correction for multiple comparisons. Percent daily intake from fat was positively associated with liking for the HF/HS milkshake and negatively associated with liking for the LF/LS milkshake over 4 years. Together, these results demonstrate that lower sensitivity to sweet taste is linked to increased hedonic response to high-sugar foods and increased energy intake from fat seems to condition adolescents to show increased liking for high-fat/high-sugar foods. (shrink)

In this paper, we propose a novel account of desire reports, i.e. sentences of the form 'S wants p'. Our theory is partly motivated by Phillips-Brown's (2021) observation that subjects can desire things even if those things aren't best by the subject's lights. That is, being best isn't necessary for being desired. We compare our proposal to existing theories, and show that it provides a neat account of the central phenomenon.

In this paper, I draw attention to comparative preference claims, i.e. sentences of the form \S prefers p to q\. I show that preference claims exhibit interesting patterns, and try to develop a semantics that captures them. Then I use my account of preference to provide an analysis of desire. The resulting entry for desire ascriptions is independently motivated, and finds support from a wide range of phenomena.

One of the central topics in semantic theory over the last few decades concerns the nature of local contexts. Recently, theorists have tried to develop general, non-stipulative accounts of local contexts (Schlenker, 2009; Ingason, 2016; Mandelkern & Romoli, 2017a). In this paper, we contribute to this literature by drawing attention to the local contexts of subclausal expressions. More specifically, we focus on the local contexts of quantificational determiners, e.g. `all', `both', etc. Our central tool for probing the local contexts of (...) subclausal elements is the principle Maximize Presupposition! (Percus, 2006; Singh, 2011). The empirical basis of our investigation concerns some data discussed by Anvari (2018b), e.g. the fact that sentences such as `All of the two presidential candidates are crooked' are unacceptable. In order to explain this, we suggest that the local context of determiners needs to contain the information carried by their restrictor. However, no existing non-stipulative account predicts this. Consequently, we think that the local contexts of subclausal expressions will likely have to be stipulated. This result has important consequences for debates in semantics and pragmatics, e.g. those around the so-called "explanatory problem" for dynamic semantics (Soames, 1982; Heim, 1990; Schlenker, 2009). (shrink)

The topic of the paper is at the intersection of recent debates on de se thought and phenomenal intentionality. An interesting problem for phenomenal intentionality is the question of how to account for the intentional properties of de se thought-contents---i.e., thoughts about oneself as oneself. Here, I aim to describe and consider the significance of a phenomenological perspective on self-consciousness in its application to de se thought. I argue that having de se thoughts can be explained in terms of the (...) ways that subjects consciously attend to themselves in experiences of thinking. Therefore, a strong form of first-person persectivalness, in which the subject is capable of self-directed control of the focus of conscious attention, is required for de se thought. But no constraints on the semantic content of such thoughts are required. The outcome of the question therefore bears importantly on both on the problem of self-reflexive self-reference and the wider problem of self-consciousness. My model suggests phenomenologically-derived conceptual constraints for the extension of minimal, background forms of self-awareness to robust, cognitive forms of self-awareness that have been of interest in recent empirical studies on self-consciousness. The framework therefore provides a way of operationalizing the concept of self-reflexive consciousness by deploying widely deployed notions from the empirical literature such as attention and minimal phenomenal selfhood, enabling a framework for empirically falsifiable hypotheses about the neural mechanisms underlying the structure of self-consciousness. What Is it Like to Think about Oneself? De Se Thought and Phenomenal Intentionality. (shrink)

The topic of the paper is at the intersection of recent debates on de se thought and phenomenal intentionality. An interesting problem for phenomenal intentionality is the question of how to account for the intentional properties of de se thought-contents---i.e., thoughts about oneself as oneself. Here, I aim to describe and consider the significance of a phenomenological perspective on self-consciousness in its application to de se thought. I argue that having de se thoughts can be explained in terms of the (...) ways that subjects consciously attend to themselves in experiences of thinking. Therefore, a strong form of first-person persectivalness, in which the subject is capable of self-directed control of the focus of conscious attention, is required for de se thought. But no constraints on the semantic content of such thoughts are required. The outcome of the question therefore bears importantly on both on the problem of self-reflexive self-reference and the wider problem of self-consciousness. My model suggests phenomenologically-derived conceptual constraints for the extension of minimal, background forms of self-awareness to robust, cognitive forms of self-awareness that have been of interest in recent empirical studies on self-consciousness. The framework therefore provides a way of operationalizing the concept of self-reflexive consciousness by deploying widely deployed notions from the empirical literature such as attention and minimal phenomenal selfhood, enabling a framework for empirically falsifiable hypotheses about the neural mechanisms underlying the structure of self-consciousness. What Is it Like to Think about Oneself? De Se Thought and Phenomenal Intentionality. (shrink)

Knowledge is good, ignorance is bad. So it seems, anyway. But in this dissertation, I argue that some ignorance is epistemically valuable. Sometimes, we should suspend judgment even though by believing we would achieve knowledge. In this apology for ignorance (ignorance, that is, of a certain kind), I defend the following four theses: 1) Sometimes, we should continue inquiry in ignorance, even though we are in a position to know the answer, in order to achieve more than mere knowledge (e.g. (...) understanding) while minimizing the effects of confirmation bias. 2) It’s false that we should believe every proposition such that we are guaranteed to be right about it (and even such that we are guaranteed to know it) if we believe it. 3) Being in a position to know is the norm of assertion: importantly, this does not require belief or (thereby) knowledge, and so proper assertion can survive speaker-ignorance. 4) It can be permissible and conversationally useful to tell audiences things that it is logically impossible for them to come to know: Proper assertion can survive (necessary) audience-side ignorance. Cumulatively, this project suggests that, properly understood, ignorance has an important role to play in the good epistemic life. (shrink)

Ethicists are typically willing to grant that thick terms (e.g. ‘courageous’ and ‘murder’) are somehow associated with evaluations. But they tend to disagree about what exactly this relationship is. Does a thick term’s evaluation come by way of its semantic content? Or is the evaluation pragmatically associated with the thick term (e.g. via conversational implicature)? In this paper, I argue that thick terms are semantically associated with evaluations. In particular, I argue that many thick concepts (if not all) conceptually entail (...) evaluative contents. The Semantic View has a number of outspoken critics, but I shall limit discussion to the most recent--Pekka Väyrynen--who believes that objectionable thick concepts present a problem for the Semantic View. After advancing my positive argument in favor of the Semantic View (section II), I argue that Väyrynen’s attack is unsuccessful (section III). One reason ethicists cite for not focusing on thick concepts is that such concepts are supposedly not semantically evaluative whereas traditional thin concepts (e.g. good and wrong) are. But if my view is correct, then this reason must be rejected. (shrink)

According to G E Moore,1 we commit the naturalistic fallacy when we infer ‘x is good’ from non-evaluative premises involving x such as ‘ x is pleasant’ or ‘ x is desired’. On Moore’s view, the mistake is to think that we can reduce moral goodness to anything else or explain it in any other terms. We cannot analyse ‘good’, Moore thought, because goodness is simple, non-natural and sui generis. If Moore were alive today, and if he were to ask (...) contemporary bioethicists the right questions, he would probably find that many of them commit the naturalistic fallacy when they move from empirical premises to normative conclusions or when they articulate complex notions of the good. Pugh et al 2 might commit the naturalistic fallacy themselves when they conclude that people with natural immunity to COVID-19 should be exempt from vaccine mandates because such exemptions would achieve desired public health benefits. Moore would probably find me guilty of committing the naturalistic fallacy if I were to present my arguments against such exemptions. A reanimated Moore would find that the naturalistic fallacy pervades bioethics and public health. In contrast, as I shall argue, the un naturalistic fallacy is probably nowhere to be found. In this commentary, I explain what the so-called unnaturalistic fallacy really is and raise doubts about whether anyone really commits it. Decades after Moore published Principia Ethica, Bernard Williams observed that the naturalistic fallacy is unfortunately named since it is neither a fallacy nor an argumentative tendency unique to ethical naturalists.3 Ethical non-naturalists make the same mistake—if it is a mistake—when they move from, say, ‘x is commanded by the gods’ to ‘x is good’. Just as Moore’s ‘naturalistic fallacy’ misnames, Pugh et al ’s ‘unnaturalistic fallacy’ misleads. To be …. (shrink)