Since the late 1960s, the legal doctrine of consent has occasionally been subject to severe criticism from within the bioethical discourse. The criticism was often based on observations indicating that consents and refusals, which had been considered valid from legal or institutional points of view, had frequently failed to reflect genuinely autonomous decision making, hence genuinely autonomous choices.This has led several critics to conclude that informed consent is a legal fiction. To clarify the concept, a legal fiction is (...) a supposition of fact taken to be true by the courts of law, irrespective of whether it is true or not, and even though it might not be true .1 What these critics probably meant to say was that the law deems any person who has given a legally valid consent to be genuinely task specifically autonomous, regardless of whether this is true or not and even though it might not be true. In other words, informed consent is a legal fiction, since it presupposes—that is, claims to reflect—genuine task specific autonomy, however baselessly.It was precisely this potentially embarrassing conclusion that prompted Faden and Beauchamp to develop a brilliant and remarkably effective argument in defence of the legal doctrine of consent. In their seminal work, AHistory and Theory of Informed Consent, they indeed acknowledged that effective consent often fails to be compatible with autonomous authorisation . Indeed, they recognised that effective consent does not necessarily entail autonomous authorisation. They argued, however, that the former is not a legal fiction, since it does not presuppose the …. (shrink)

Despite resistance from various societal actors, the development and deployment of lethal autonomous weaponry to warzones is perhaps likely, considering the perceived operational and ethical advantage such weapons are purported to bring. In this paper, it is argued that the deployment of truly autonomous weaponry presents an ethical danger by calling into question the ability of such weapons to abide by the Laws of War. This is done by noting the resonances between battlefield target identification and the process (...) of ontic-ontological investigation detailed in Martin Heidegger’s Being and Time, before arguing that the nature of lethal autonomous weaponry precludes them from being able to engage in such investigations—a key requisite for abiding by the relevant legislation that governs battlefield conduct. (shrink)

Kant’s commitment to autonomy raises difficult questions about the very possibility of Kantian moral education, since appeal to external pedagogical guidance threatens to be in contradiction with autonomous virtue. Furthermore, moral education seems to involve getting good at something through repetition; but Kant seems to eschew the notion of repeated natural activity as antithetical to autonomy. Things become even trickier once we remember that Kant also views autonomous human beings as radically evil: we are capable of choosing rationally (...) and autonomously, but, left to our own devices, that same capacity for reason might tempt us to choose only out of a concern to satisfy our happiness. We thus need a moral education which realizes autonomy while dodging the dual bullets of external natural forces and internal evil forces. Ultimately, his concerns about external natural forces and internal evil forces do not lead Kant to reject either moral education or a role for repeated activity in it. Rathe... (shrink)

While there are many issues to be raised in using lethal autonomous robotic weapons (beyond those of remotely operated drones), we argue that the most important question is: should the decision to take a human life be relinquished to a machine? This question is often overlooked in favor of technical questions of sensor capability, operational questions of chain of command, or legal questions of sovereign borders. We further argue that the answer must be ?no? and offer several reasons for (...) banning autonomous robots. (1) Such a robot treats a human as an object, instead of as a person with inherent dignity. (2) A machine can only mimic moral actions, it cannot be moral. (3) A machine run by a program has no human emotions, no feelings about the seriousness of killing a human. (4) Using such a robot would be a violation of military honor. We therefore conclude that the use of an autonomous robot in lethal operations should be banned. (shrink)

In this paper I examine some of the significant moral concerns inherent in cases of treatment refusal involving patients with psychotic disorders. In particular, I explore the relevance of the principle of autonomy in such situations. After exploring the concept of autonomy and explaining its current and historical significance in a health care setting, I argue that because autonomous choice depends for its existence upon certain human functions such as the ability to reason, judge, and assess consequences, patients cannot (...) be said to be making free and autonomous decisions if these capacities are compromised. I contend further that because psychotic disorders have the potential to compromise these functions in the future, it is appropriate, in some limited cases, to coerce patients with psychotic disorders to undergo treatment in order to preserve their future decision-making capacities and to protect their ability to recognize and respect the autonomy of others. (shrink)

ABSTRACTAutonomous weapons systems pose many challenges in complex battlefield environments. Previous discussions of them have largely focused on technological or policy issues. In contrast, we focus here on the challenge of trust in an AWS. One type of human trust depends only on judgments about the predictability or reliability of the trustee, and so are suitable for all manner of artifacts. However, AWSs that are worthy of the descriptor “autonomous” will not exhibit the required strong predictability in the complex, (...) changing contexts of war. Instead, warfighters need to develop deeper, interpersonal trust that is grounded in understanding the values, beliefs, and dispositions of the AWS. Current acquisition, training, and deployment processes preclude the development of such trust, and so there are currently no routes for a warfighter to develop trust in an AWS. We thus survey three possible changes to current practices in order to facilitate the type of deep trust that is required for appropri... (shrink)

The present debate over the creation and potential deployment of lethal autonomous weapons, or ‘killer robots’, is garnering more and more attention. Much of the argument revolves around whether such machines would be able to uphold the principle of noncombatant immunity. However, much of the present debate fails to take into consideration the practical realties of contemporary armed conflict, particularly generating military objectives and the adherence to a targeting process. This paper argues that we must look to the targeting (...) process if we are to gain a fuller picture of the consequences of creating or fielding lethal autonomous robots. This paper argues that once we look to how militaries actually create military objectives, and thus identify potential targets, we face an additional problem: the Strategic Robot Problem. The ability to create targeting lists using military doctrine and targeting processes is inherently strategic, and handing this capability over to a machine undermines existing comman.. (shrink)

The thesis of this bk is that the brain is innately constructed to initiate behaviors likely to promote the survival of the species & to sensitize sensory systems to stimuli required for those behaviors. Intended for behavioral & brain scientists.

The design of collaborative robotics, such as driver-assisted operations, engineer a potential automation of decision-making predicated on unobtrusive data gathering of human users. This form of ‘somatic surveillance’ increasingly relies on behavioural biometrics and sensory algorithms to verify the physiology of bodies in cabin interiors. Such processes secure cyber-physical space, but also register user capabilities for control that yield data as insured risk. In this technical re-formation of human–machine interactions for control and communication ‘a dissonance of attribution’ :7684, 2019. https://doi.org/10.1073/pnas.1805770115) (...) is created between perceptions of phenomena, materials and decision-making. This reconfigures relations not only between humans and machines, objects and subjects, but possibly disrupts attributive functions in the social system of Law. What it requires is shifting a legal accountability for action from a sovereignty of the human to a new materialist account based on a ‘cognitive assemblage’ between physiological data, computation and algorithmic sensing. This paper investigates the function of law as a guidance system to acknowledge this account of sensory and algorithmic computation as autonomous ‘sensing agents’ that may be accountable in situations of risk. This assemblage of robotic computation and sensory determination requires a clearer legal differentiation across the current static terminologies of person, property, liability and rights that maintain strict separations of object from subject. To neglect this, we argue, law will solely impute attributions of error to humans despite evidence of operation via mutual control. (shrink)

In this paper I examine some of the significant moral concerns inherent in cases of treatment refusal involving patients with psychotic disorders. In particular, I explore the relevance of the principle of autonomy in such situations. After exploring the concept of autonomy and explaining its current and historical significance in a health care setting, I argue that because autonomous choice depends for its existence upon certain human functions such as the ability to reason, judge, and assess consequences, patients cannot (...) be said to be making free and autonomous decisions if these capacities are compromised. I contend further that because psychotic disorders have the potential to compromise these functions in the future, it is appropriate, in some limited cases, to coerce patients with psychotic disorders to undergo treatment in order to preserve their future decisionmaking capacities and to protect their ability to recognize and respect the autonomy of others. (shrink)

Through the World Health Organization’s definition of midwifery, midwives are frequently heard to describe themselves as autonomous practitioners. In this article this notion is refuted. An overview of individual and collective autonomy is first presented to contextualize the subsequent discussion. Then the notion of autonomy in relation to midwifery practice in Scotland and New Zealand is critiqued through tracing the history of midwives and midwifery in these two countries. Issues relating to midwifery registration, medicalization of birth and consumerism are (...) discussed. Each of these categories is suggested as limiting to autonomous practice within midwifery. (shrink)

This volume brings together the advanced research results obtained by the European COST Action 2102: “Cross Modal Analysis of Verbal and Nonverbal Communication”. The research published in this book was discussed at the 3rd joint EUCOGII-COST 2102 International Training School entitled “Toward Autonomous, Adaptive, and Context-Aware Multimodal Interfaces: Theoretical and Practical Issues ” and held in Caserta, Italy, on March 15-19, 2010.

In biobanks, a broader model of consent is often used and justified by a range of different strategies that make reference to the potential benefits brought by the research it will facilitate combined with the low level of risk involved (provided adequate measures are in place to protect privacy and confidentiality) or a questioning of the centrality of the notion of informed consent. Against this, it has been suggested that the lack of specific information about particular uses of the samples (...) means that such consent cannot be fully autonomous and so is unethical. My answer to the title question is a definite ‘yes’. Broad consent can be informed consent and is justified by appeal to the principle of respect for autonomy. Indeed, I will suggest that the distinction between the various kinds of consent is not a distinction between kinds of consent but between the kinds of choice a person makes. When an individual makes a choice (of any kind) it is important that they do so according to the standards of informed consent and consistent with the choice that they are making. (shrink)

In this article we summarise some previously described proposals for ethical governance of autonomous vehicles, critique them, and offer an alternative solution. Rather than programming cars to react to crash situations in the same way as humans, having humans program pre-set responses for a wide range of different potential scenarios, or applying particular ethical theories, we suggest that decisions should be made jointly between humans and cars. Given that humans lack the requisite processing capacity, and computers lack the necessary (...) ethical capacity, the medical paradigm of advance care planning can be retooled for this new context. Advance car-crash planning provides a way to combine humans’ ethical preferences with the advanced data processing capacities of computers to enable shared decision making in collision situations. (shrink)

The early decades of the last century saw European philosophical thought becoming increasingly interested in the sociological extension of the idea of law. From the viewpoint of the sociology of law, law is formed in the process of social interactions and is not sanctioned by the state. Sergey Hessen and Georges Gurvitch base their conceptions of social law on the sociology of law in the 1920s and 1930s. They start a polemic in the pages of the journal Sovremenniye zapiski. Although (...) they differ radically in their definitions of the status of the state they concur in defining society as a set of social institutions and communities existing as instruments for expressing personal freedom. The social regulations they propose are already legal situations. Hessen and Gurvitch believe that the individual can fully exercise his/her freedom only in conditions of such legal pluralism. However, the concept of legal pluralism involves an inherent problem of preserving social unity: why is it that society does not fall into a range of autonomous social entities, each offering the individual its own legal order for actualising freedom? To solve this problem the philosophers use the concept of “the general will”. General will is an instrument of correlation between individual freedom and the development of society and culture as a whole. The object of philosophical dispute is how the general will is formed: 1) in the process of social self-organisation according to Gurvitch; 2) in the operation of the suprafunctional organisation according to Hessen. The difference in the grounding of the general will leads to a difference in the concepts of social unity: 1) sobornost according to Gurvitch and 2) solidarity according to Hessen. Analysis of the dispute between Gurvitch and Hessen brings out not only the differences in the interpretation of social unity but also the fundamental problems with the conceptions of social law. (shrink)

Purpose – The purpose of this paper is to consider the question of equipping fully autonomous robotic weapons with the capacity to kill. Current ideas concerning the feasibility and advisability of developing and deploying such weapons, including the proposal that they be equipped with a so-called “ethical governor”, are reviewed and critiqued. The perspective adopted for this study includes software engineering practice as well as ethical and legal aspects of the use of lethal autonomous robotic weapons. Design/methodology/approach – (...) In the paper, the author survey and critique the applicable literature. Findings – In the current paper, the author argue that fully autonomous robotic weapons with the capacity to kill should neither be developed nor deployed, that research directed toward equipping such weapons with a so-called “ethical governor” is immoral and serves as an “ethical smoke-screen” to legitimize research and development of these weapons and that, as an ethical duty, engineers and scientists should condemn and refuse to participate in their development. Originality/value – This is a new approach to the argument for banning autonomous lethal robotic weapons based on classical work of Joseph Weizenbaum, Helen Nissenbaum and others. (shrink)

Kant’s commitment to autonomy raises difficult questions about the very possibility of Kantian moral education, since appeal to external pedagogical guidance threatens to be in contradictio...

As automobile manufacturers have begun to design, engineer, and test autonomous driving systems of the future, brain imaging with functional near-infrared spectroscopy can provide unique insights about cognitive processes associated with evolving levels of autonomy implemented in the automobile. Modern fNIRS devices provide a portable, relatively affordable, and robust form of functional neuroimaging that allows researchers to investigate brain function in real-world environments. The trend toward “naturalistic neuroscience” is evident in the growing number of studies that leverage the methodological (...) flexibility of fNIRS, and in doing so, significantly expand the scope of cognitive function that is accessible to observation via functional brain imaging. While more than a decade’s worth of study in this field of fNIRS driving research has led to many interesting findings, the number of studies applying fNIRS during autonomous modes of operation is limited. To support future research that directly addresses this lack in autonomous driving research with fNIRS, we argue that a cogent distillation of the methods used to date will help facilitate and streamline this research of tomorrow. To that end, here we provide a methodological review of the existing fNIRS driving research, with the overarching goal of highlighting the current diversity in methodological approaches. We argue that standardization of these approaches will facilitate greater overlap of methods by researchers from all disciplines, which will, in-turn, allow for meta-analysis of future results. We conclude by providing recommendations for advancing the use of such fNIRS technology in furthering understanding the adoption of safe autonomous vehicle technology. (shrink)

This article contends that certain types of Autonomous Weapons Systems (AWS) are susceptible to Hume’s Law. Hume’s Law highlights the seeming impossibility of deriving moral judgments, if not all evaluative ones, from purely factual premises. If autonomous weapons make use of factual data from their environments to carry out specific actions, then justifying their ethical decisions may prove to be intractable in light of the said problem. In this article, Hume’s original formulation of the no-ought-from-is thesis is evaluated (...) in relation to the dominant views regarding it (viz., moral non-descriptivism and moral descriptivism). Citing the objections raised against these views, it is claimed that, if there is no clear-cut solution to Hume’s is-ought problem that presently exists, then the task of grounding the moral judgements of AWS would still be left unaccounted for. (shrink)

In everyday life we take it for granted that we have conscious control of some of our actions and that the part of us that exercises control is the conscious mind. Psychosomatic medicine also assumes that the conscious mind can affect body states, and this is supported by evidence that the use of imagery, hypnosis, biofeedback and other 'mental interventions' can be therapeutic in a variety of medical conditions. However, there is no accepted theory of mind/body interaction and this has (...) had a detrimental effect on the acceptance of mental causation in science, philosophy and in many areas of clinical practice. Biomedical accounts typically translate the effects of mind into the effects of brain functioning, for example, explaining mind/body interactions in terms of the interconnections and reciprocal control of cortical, neuroendocrine, autonomic and immune systems. While such accounts are instructive, they are implicitly reductionist, and beg the question of how conscious experiences could have bodily effects. On the other hand, non-reductionist accounts have to cope with three problems: (1) The physical world appears causally closed, which would seem to leave no room for conscious intervention. (2) One is not conscious of one's own brain/body processing, so how could there be conscious control of such processing? (3) Conscious experiences appear to come too late to causally affect the processes to which they most obviously relate. This paper suggests a way of understanding mental causation that resolves these problems. It also suggests that 'conscious mental control' needs to be partly understood in terms of the voluntary operations of the preconscious mind, and that this allows an account of biological determinism that is compatible with experienced free will. (shrink)

Subjective feelings of familiarity associated with a stimulus tend to be strongest when specific information about the previous encounter with the stimulus is difficult to retrieve . Recognizing: The judgment of previous occurrence. Psychological Review, 87, 252–271.]). When a stimulus has been encountered previously and the circumstances of the encounter cannot be recollected, additional cognitive resources may be directed toward recollection processes; this resource allocation is accompanied by autonomic arousal [Dawson, M. E., Filion, D. L., & Schell, A. M. . (...) Is elicitation of the autonomic orienting response associated with allocation of processing resources?. Psychophysiology, 26, 560–572]. One easily measurable index of autonomic arousal is the skin conductance response . In the present study, participants studied lists of words and then gave recognition ratings to briefly displayed and masked studied and nonstudied test words while their SCRs were monitored. Results revealed a relationship between recognition ratings and the temporal characteristics of the SCR, supporting the idea that feelings of familiarity are indeed “feelings” in that they stem from autonomic arousal associated with cognitive resource allocation. (shrink)

Danielle Wenner has crafted novel arguments in defense of republican accounts of freedom. I learned a lot from her discussion of how Philip Pettit's neorepublican account of freedom as nondomination does a better job than standard accounts of freedom as noninterference of explaining how power over an agent can restrict their freedom to act autonomously. The real crux of Wenner's argument, however, is that freedom as nondomination can do this work in a way that those who defend an account of (...) relational autonomy cannot. I will start with Wenner's defense of freedom as nondomination and of what it can do as the background for assessing her critique of relational autonomy. The upshot of my comments will be that Wenner... (shrink)

We examined the management of completed advance directives including why participants completed a document, what procedures and values they chose, with whom they held end-of-life conversations, and where they stored their document. Participants elected to complete a SurveyMonkey survey that was made available to individuals who wrote an advance directive through Texas-LivingWill.org; 491 individuals elected to fill out the survey, aged 19 to 94 years. The survey asked multiple questions about why participants completed an advance directive, where they would store (...) it, and with whom they had conversations about their end-oflife wishes. A list of procedures and values allowed participants to indicate what they refused or requested in their advance directive. Advance directives are most often completed to allow patients to prepare and control the healthcare they wish to receive when dying. One-half to two-thirds of individuals refuse common end-of-life medical procedures, and the rest request the procedures. We found a correlation between the choice to refuse or request a procedure and the age of the participant. Participants reported that their end-of-life conversations most often occurred with their spouse. Respondents often reported that their advance directive was stored with their physician and power of attorney for healthcare, conversations with those individuals rarely happened. Advance directives document patients’ requests for and refusals of end-of-life care. Physicians and surrogates need to be better educated so that the documents are part of a meaningful conversation with the patient. Because patients’ choices change over their lifespan, these documents need to be revisited regularly and not completed as a onetime event. (shrink)

Recent advances in wireless technologies have led to the development of intelligent, in-vehicle safety applications designed to share information about the actions of nearby vehicles, potential road hazards, and ultimately predict dangerous scenarios or imminent collisions. These vehicle safety communication (VSC) technologies rely on the creation of autonomous, self-organizing, wireless communication networks connecting vehicles with roadside infrastructure and with each other. As the technical standards and communication protocols for VSC technologies are still being developed, certain ethical implications of these (...) new information technologies emerge: Coupled with the predicted safety benefits of VSC applications is a potential rise in the ability to surveil a driver engaging in her everyday activities on the public roads. This paper will explore how the introduction of VSC technologies might disrupt the “contextual integrity” of personal information flows in the context of highway travel and threaten one’s “privacy in public.” Since VSC technologies and their related protocols and standards are still in the developmental stage, the paper will conclude by revealing how close attention to the ethical implications of the remaining design decisions can inform and guide designers of VSC technologies to create innovate safety applications that increase public safety, but without compromising the value of one’s privacy in public. (shrink)

In a recent paper, Kaplan (Synthese 183:339–373, 2011) takes up the task of extending Craver’s (Explaining the brain, 2007) mechanistic account of explanation in neuroscience to the new territory of computational neuroscience. He presents the model to mechanism mapping (3M) criterion as a condition for a model’s explanatory adequacy. This mechanistic approach is intended to replace earlier accounts which posited a level of computational analysis conceived as distinct and autonomous from underlying mechanistic details. In this paper I discuss work (...) in computational neuroscience that creates difficulties for the mechanist project. Carandini and Heeger (Nat Rev Neurosci 13:51–62, 2012) propose that many neural response properties can be understood in terms of canonical neural computations. These are “standard computational modules that apply the same fundamental operations in a variety of contexts.” Importantly, these computations can have numerous biophysical realisations, and so straightforward examination of the mechanisms underlying these computations carries little explanatory weight. Through a comparison between this modelling approach and minimal models in other branches of science, I argue that computational neuroscience frequently employs a distinct explanatory style, namely, efficient coding explanation. Such explanations cannot be assimilated into the mechanistic framework but do bear interesting similarities with evolutionary and optimality explanations elsewhere in biology. (shrink)

Autonomy has been hailed as the foremost principle of bioethics, and yet patients’ decisions and research subjects’ voluntary participation are being subjected to frequent restrictions. It has been argued that patient care is best served by a limited form of paternalism because the doctor is better qualified to take critical decisions than the patient, who is distracted by illness. The revival of paternalism is unwarranted on two grounds: firstly, because prejudging that the sick are not fully autonomous is a (...) biased and unsubstantial view; secondly, because the technical knowledge of healthcare professionals does not include the ethical qualifications and prerogative to decide for others.Clinical research settings are even more prone to erode subjects’ autonomy than clinical settings because of the tendency and temptation to resort to such practices as shading the truth when consent to participation is sought, or waiving consent altogether when research is done in emergency settings.Instead of supporting such dubious practices with unconvincing arguments, it would seem to be the task of bioethics to insist on reinforcing autonomy. (shrink)

Ensuring the trustworthiness of autonomous systems and artificial intelligence is an important interdisciplinary endeavour. In this position paper, we argue that this endeavour will benefit from technical advancements in capturing various forms of responsibility, and we present a comprehensive research agenda to achieve this. In particular, we argue that ensuring the reliability of autonomous system can take advantage of technical approaches for quantifying degrees of responsibility and for coordinating tasks based on that. Moreover, we deem that, in certifying (...) the legality of an AI system, formal and computationally implementable notions of _responsibility_, _blame_, _accountability_, and _liability_ are applicable for addressing potential responsibility gaps (i.e. situations in which a group is responsible, but individuals’ responsibility may be unclear). This is a call to enable AI systems themselves, as well as those involved in the design, monitoring, and governance of AI systems, to represent and reason about who can be seen as responsible in prospect (e.g. for completing a task in future) and who can be seen as responsible retrospectively (e.g. for a failure that has already occurred). To that end, in this work, we show that across all stages of the design, development, and deployment of trustworthy autonomous systems (TAS), responsibility reasoning should play a key role. This position paper is the first step towards establishing a road map and research agenda on how the notion of responsibility can provide novel solution concepts for ensuring the _reliability_ and _legality_ of TAS and, as a result, enables an effective embedding of AI technologies into society. (shrink)

Introduction It is increasingly considered important that people make an autonomous and informed decision concerning colorectal cancer screening. However, the realisation of autonomy within the concept of informed decision-making might be interpreted too narrowly. Additionally, relatively little is known about what the eligible population believes to be a 'good' screening decision. Therefore, we aimed to explore how the concepts of autonomous and informed decision-making relate to how the eligible CRC screening population makes their decision and when they believe (...) to have made a 'good' screening decision. Methods We conducted 27 semi-structured interviews with the eligible CRC screening population. The general topics discussed concerned how people made their CRC screening decision, how they experienced making this decision and when they considered they had made a 'good' decision. Results Most interviewees viewed a 'good' CRC screening decision as one based on both reasoning and feeling/intuition, and that is made freely. However, many CRC screening non-participants experienced a certain social pressure to participate. All CRC screening non-participants viewed making an informed decision as essential. This appeared to be the case to a lesser extent for CRC screening participants. For most, experiences and values were involved in their decision-making. Conclusion Our sample of the eligible CRC screening population viewed aspects related to the concepts of autonomous and informed decision-making as important for making a 'good' CRC screening decision. However, in particular the existence of a social norm may be affecting a true autonomous decision-making process. Additionally, the present concept of informed decision-making with its strong emphasis on making a fully informed and well-considered decision does not appear to be entirely reflective of the process in practice. More efforts could be made to attune to the diverse values and factors that are involved in deciding about CRC screening participation. (shrink)

The ongoing debate on the ethics of using artificial intelligence (AI) in military contexts has been negatively impacted by the predominant focus on the use of lethal autonomous weapon systems (LAWS) in war. However, AI technologies have a considerably broader scope and present opportunities for decision support optimization across the entire spectrum of the military decision-making process (MDMP). These opportunities cannot be ignored. Instead of mainly focusing on the risks of the use of AI in target engagement, the debate (...) about responsible AI should (i) concern each step in the MDMP, and (ii) take ethical considerations and enhanced performance in military operations into account. A characterization of the debate on responsible AI in the military, considering both machine and human weaknesses and strengths, is provided in this paper. We present inroads into the improvement of the MDMP, and thus military operations, through the use of AI for decision support, taking each quadrant of this characterization into account. (shrink)

Background: Informed consent is regarded as a contract between autonomous and equal parties and requires the elements of information disclosure, understanding, voluntariness and consent. The validity of informed consent for critically ill patients has been questioned. Little is known about how these patients experience the process of consent.Objective: The aim of this study was to explore critically ill patients’ experience with the principle of informed consent in a clinical trial and their ability to give valid informed consent.Design: 11 stroke (...) patients who had been informed about thrombolytic treatment and had been through the process of deciding whether or not to participate in a thrombolysis trial went through repeated qualitative semistructured interviews.Results: None of the patients had any clear understanding of the purpose of the trial. Neither did they understand the principles of randomisation and voluntariness. Reasons for giving or not giving consent were trust, conceptions of benefits and risks and altruism. Several patients found it immoral to involve patients in the consent procedure and argued that this was the doctors’ responsibility. Others argued that it is a duty to question patients and perceived it as a sign of being treated with respect and dignity. A majority of the patients found the consent process vague and ambiguous.Conclusions: The results indicate that the principle of informed consent from critically ill patients cannot be seen as a contract between equal and autonomous parties. Further studies are needed to explore critically ill patients’ experiences with the process of informed consent. (shrink)

The urgency of the resuscitation and the impaired ability of the patient to make a reasonable autonomous decision both conspire against adequate consideration of the principles of medical ethics. Informed consent is usually not possible for these reasons and this leads many to consider that consent is not required for resuscitation, because resuscitation brings benefit and prevents harm and because the patient is not in a position to give or withhold consent. However, consent for resuscitation is required and the (...) common models employed for this purpose are presumed consent or consent from a patient proxy. However, if we are to honour the principles of respect for patient autonomy, as well as beneficence and non-maleficence, when starting and continuing resuscitation we must try and achieve the best balance between benefit and harm from the patient's perspective. The concept of professional substituted judgment involves the resuscitators gathering as much information about the patient as they possibly can, including any previously expressed attitudes towards such a situation, and combining this with their acquired professional knowledge of the likely benefits and harms of the resuscitation endeavour and then exercising their moral imagination, imagining themselves as the patient, and asking "would I want this treatment?" By employing professional substituted judgment resuscitators should recognise when the balance of benefit and harm becomes unfavourable from the patient's perspective and at this point they have a moral obligation to withdraw resuscitation as they can no longer presume the patient's consent. In this way the principles of beneficence, non-maleficence and respect for patient autonomy are more favourably balanced than under other resuscitation decision making processes. (shrink)

The number of young people who grew up in the new, democratic conditions of an independent Ukrainian state, where the democratic foundations of freedom of conscience and religion are laid down, is constantly increasing. Youth is the founders and foundation of many religious movements in Ukraine. Thus, the Christian charismatic movement in Ukraine does not go without youth. It arose on the basis of the autonomous Pentecostal and youth wing of the Baptist communities. And now this current of Protestantism (...) fills its ranks at the expense of young adherents. (shrink)

This paper challenges the role individual autonomy has played in debates on moral neuroenhancement (MN). It shows how John Hyman’s analysis of agency as consisting of functionally integrated dimensions allows us to reassess the impact of MN on practical agency. I discuss how MN affects what Hyman terms the four dimensions of agency: psychological, ethical, intellectual, and physical. Once we separate the different dimensions of agency, it becomes clear that many authors in the debate conflate the different dimensions in the (...) concept they call ‘autonomous agents’. They contend that, for example, reason-giving and previous autonomous acts are relevant to agency as such, when in fact they capture only one aspect of functionally integrated agency. This paper reconsiders MN in light of the functional integration of reason and emotions in practical agency. To illustrate the impact of MN on different aspects of agency, I consider examples from legal practice, which show that autonomy cannot be our sole focus when evaluating the moral implications of MN. (shrink)

Autonomous sensory meridian response is a complex sensory-emotional experience characterized by pleasant tingling sensations initiating at the scalp. ASMR is triggered in some people by stimuli including whispering, personal attention, and crisp sounds. Since its inception, ASMR has been likened to synesthesia, but convincing empirical data directly linking ASMR with synesthesia is lacking. In this study, we examined whether the prevalence of synesthesia is indeed significantly higher in ASMR-responders than non-responders. A sample of working adults and students were surveyed (...) about their experience with ASMR and common types of synesthesia. The proportion of synesthetes who were classified as ASMR-responders was 52%, whereas 22% of ASMR-responders were also synesthetes. These results suggest that: over half of those identifying as synesthetes also experience ASMR, and that synesthesia is up to four times as common among ASMR-responders as among non-responders. Findings also suggest a prevalence rate for ASMR of approximately 20%. Overall, the co-occurrence of ASMR and synesthesia lends empirical support to the idea that ASMR may be driven by synesthetic mechanisms, but future research would benefit from examining how ASMR and synesthesia are different, as well as similar. (shrink)

In their “social contextual view” of emotional mimicry, authors Hess and Fischer (2022) put forward emotional mimicry as a social regulator, considering it a social act, bound to certain affiliative contexts or goals. In this commentary, we argue that the core function of mimicry is to ease predicting conspecifics’ behaviours and the environment, and that as a consequence, this often smoothens social interactions. Accordingly, we make three main points. First, we argue that there is no good reason to believe that (...) the mimicry of negative expressions is fundamentally different than the mimicry of positive or ambiguous or autonomic expressions. Second, we give examples of empirical evidence that mimicry is not always a social act. Third, we show that mimicry has primary benefits for the mimicker. As such, we will briefly summarise and elaborate on the relevant findings in these respects, and propose a comparative, multi-method and ecologically valid approach which can explain the multifaceted character of the phenomenon. (shrink)

Construction of a robot discoverer can be treated as the ultimate success of automated discovery. In order to build such an agent we must understand algorithmic details of the discovery processes and the representation of scientific knowledge needed to support the automation. To understand the discovery process we must build automated systems. This paper investigates the anatomy of a robot-discoverer, examining various components developed and refined to a various degree over two decades. We also clarify the notion of autonomy of (...) an artificial agent, and we discuss the ways in which machine discoverers become more autonomous. Finally we summarize the main principles useful in construction of automated discoverers and we discuss various possible limitations of automation. (shrink)