This paper sheds light on the role of digital platform labour in the development of today’s artificial intelligence, predicated on data-intensive machine learning algorithms. Focus is on the specific ways in which outsourcing of data tasks to myriad ‘micro-workers’, recruited and managed through specialized platforms, powers virtual assistants, self-driving vehicles and connected objects. Using qualitative data from multiple sources, we show that micro-work performs a variety of functions, between three poles that we label, respectively, ‘artificial intelligence preparation’, ‘artificial intelligence verification’ (...) and ‘artificial intelligence impersonation’. Because of the wide scope of application of micro-work, it is a structural component of contemporary artificial intelligence production processes – not an ephemeral form of support that may vanish once the technology reaches maturity stage. Through the lens of micro-work, we prefigure the policy implications of a future in which data technologies do not replace human workforce but imply its marginalization and precariousness. (shrink)

The increasing complexity of human subjects research and its oversight has prompted researchers, as well as institutional review boards, to have a forum in which to discuss challenging or novel ethical issues not fully addressed by regulations. Research ethics consultation services provide such a forum. In this article, we rely on the experiences of a national Research Ethics Consultation Collaborative that collected more than 350 research ethics consultations in a repository and published 18 challenging cases with accompanying ethical commentaries to (...) highlight four contexts in which REC can be a valuable resource. REC assists: 1) investigators before and after the regulatory review; 2) investigators, IRBs, and other research administrators facing challenging and novel ethical issues; 3) IRBs and investigators with the increasing challenges of informed consent and risk/benefit analysis; and 4) in providing flexible and collaborative assistance to overcome study hurdles, mediate conflicts within a team, or directly engage with research participants. Institutions that have established, or plan to establish, REC services should work to raise the visibility of their service and engage in open communication with existing clinical ethics consult services as well as the IRB. While the IRB system remains the foundation for the ethical review of research, REC can be a valuable service for investigators, regulators, and research participants aligned with the goal of supporting ethical research. (shrink)

The aim of J.-L. Marion’s article is to revisit the important debate on the place of Augustine in the history of metaphysics. Often, quibbles arise upon considering the use of substance (substantia) by Augustine, not only as approximative of essentia and as synonymous with ousia, but in deciding whether in so doing Augustine effectuates a ‘metaphysical turn’. While he elsewhere argues that Augustine is a pre-metaphysical thinker, in this article Marion focuses on showing the diverse range of usages (...) of the term substance in the Augustinian corpus. Marion observes: first, whenever substance seems a fixed definition, the term allows for equivocity; second, God is substance in an indeterminate sense or by negation; third, human beings are substances fundamentally to capture the mutability of human existence. As such, Marion concludes, the Augustinian use of substance is insufficient to inelude Augustine in the history of metaphysics. (shrink)

The required professional and ethical pronouncements of accountants mean that auditors need to be competent and exercise due care and skill in the performance of their audits. In this study, we examine what happens when auditors take on more clients than they should, thus raising doubts about their ability to maintain competence and audit quality. Using 2803 observations of Malaysian companies from 2010 to 2013, we find that auditors with multiple clients are associated with lower earnings quality, proxied by total (...) accruals and discretionary accruals. Our results demonstrate that associating client firms’ reported discretionary accruals with individual auditors, rather than their firms or offices, is important in determining audit quality. Moreover, we demonstrate that the disclosure of auditors’ signatures on their reports is useful for assessing auditor quality at the individual level, thus contributing to the debate on the usefulness of having auditor identities on reports. (shrink)

One of the most striking findings of the study by Foglia and colleagues (2009) was that clinicians and managers were most concerned with limited resources while ethics committee chairpersons focuse...

Although rationing by clinical judgment is controversial, its acceptability partly depends on how it is practiced. In this paper, rationing by clinical judgment is defined in three different circumstances that represent increasingly wider circles of resource pools in which the rationing decision takes place: triage during acute shortage, comparison to other potential patients in a context of limited but not immediately strained resources, and determination of whether expected benefit of an intervention is deemed sufficient to warrant its cost by reference (...) to published population based thresholds. Notions of procedural justice are applied along with an analytical framework of six minimal requisites in order to facilitate fair bedside rationing: (1) a closed system that offers reciprocity, (2) attention to general concerns of justice, (3) respect for individual variations, (4) application of a consistent process, (5) explicitness, and (6) review of decisions. The process could be monitored for its applicability and appropriateness. (shrink)

Clinical ethics support services are developing in Europe. They will be most useful if they are designed to match the ethical concerns of clinicians. We conducted a cross-sectional mailed survey on random samples of general physicians in Norway, Switzerland, Italy, and the UK, to assess their access to different types of ethics support services, and to describe what makes them more likely to have used available ethics support. Respondents reported access to formal ethics support services such as clinical ethics committees (...) (23%), consultation in individual cases (17.6%), and individual ethicists (8.8%), but also to other kinds of less formal ethics support (23.6%). Access to formal ethics support services was associated with work in urban hospitals. Informal ethics resources were more evenly distributed. Although most respondents (81%) reported that they would find help useful in facing ethical difficulties, they reported having used the available services infrequently (14%). Physicians with greater confidence in their knowledge of ethics (P = 0.001), or who had had ethics courses in medical school (P = 0.006), were more likely to have used available services. Access to help in facing ethical difficulties among general physicians in the surveyed countries is provided by a mix of official ethics support services and other resources. Developing ethics support services may benefit from integration of informal services. Development of ethics education in medical school curricula could lead to improved physicians sensititity to ethical difficulties and greater use of ethics support services. Such support services may also need to be more proactive in making their help available. (shrink)

Examines the relationship between the question of God and the destiny of metaphysics. Concept of the end of metaphysics; Ambiguous relation between phenomenology and metaphysics; Return of special metaphysics in phenomenology; Phenomenological figure of God. Examines the relationship between the question of God and the destiny of metaphysics. Concept of the end of metaphysics; Ambiguous relation between phenomenology and metaphysics; Return of special metaphysics in phenomenology; Phenomenological figure of God.

Experiential evidence shows that pain is associated with common meanings. These include a meaning of threat or danger, which is experienced as immediately distressing or unpleasant; cognitive meanings, which are focused on the long-term consequences of having chronic pain; and existential meanings such as hopelessness, which are more about the person with chronic pain than the pain itself. This interdisciplinary book - the second in the three-volume Meanings of Pain series edited by Dr Simon van Rysewyk - aims to better (...) understand pain by describing experiences of pain and the meanings these experiences hold for the people living through them. The lived experiences of pain described here involve various types of chronic pain, including spinal pain, labour pain, rheumatic pain, diabetic peripheral neuropathic pain, fibromyalgia, complex regional pain syndrome, endometriosis-associated pain, and cancer-related pain. Two chapters provide narrative descriptions of pain, recounted and interpreted by people with pain. Language is important to understanding the meaning of pain since it is the primary tool human beings use to manipulate meaning. As discussed in the book, linguistic meaning may hold clues to understanding some pain-related experiences, including the stigmatisation of people with pain, the dynamics of patient-clinician communication, and other issues, such as relationships between pain, public policy and the law, and attempts to develop a taxonomy of pain that is meaningful for patients. Clinical implications are described in each chapter. This book is intended for people with pain, their family members or caregivers, clinicians, researchers, advocates, and policy makers. (shrink)

The domain of children's social understanding, including understanding of one's own and others’ minds and emotions, has been the topic of much research over the past few decades. Social understandi...

Is there anything that members of each binary category of gender have in common? Even many non-essentialists find the lack of unity within a gender worrying as it undermines the basis for a common political agenda for women. One promising proposal for achieving unity is by means of a shared historical lineage of cultural reproduction with past binary models of gender. I demonstrate how such an account is likely to take on board different binary and also non-binary systems of gender. (...) This implies that all individuals construed as members of the category, “women” are in fact not members of the same historical kind after all! I then consider different possible means of modifying the account but conclude negatively: the problem runs deeper than has been appreciated thus far. (shrink)

As a contribution to a wider discussion on moral discernment in theological anthropology, this paper seeks to answer the question “What is the impact of mental illness on an individual’s ability to make moral decisions?” Written from a clinical psychiatric perspective, it considers recent contributions from psychology, neuropsychology and imaging technology. It notes that the popular conception that mental illness necessarily robs an individual of moral responsibility is largely unfounded. Most people who suffer from mental health problems do not lose (...) the capacity to make moral decisions, and mental illness on its own rarely explains anti-social or criminal behaviour. Moreover, the assumptions of some scientists, that recent developments in neuropsychology and brain imaging suggest biological determinism, must be treated with caution. (shrink)

Natural kinds is a widely used and pivotal concept in philosophy – the idea being that the classifications and taxonomies employed by science correspond to the real kinds in nature. Natural kinds are often opposed to the idea of kinds in the human and social sciences, which are typically seen as social constructions, characterised by changing norms and resisting scientific reduction. Yet human beings are also a subject of scientific study.Does this mean humans fall into corresponding kinds of their own? (...) In The Epistemology and Morality of Human Kinds Marion Godman defends the idea of human kinds. She first examines the scientific use and nature of human kinds, considering the arguments of key philosophers whose work bears upon human kinds, such as Ian Hacking, John Searle, Richard Boyd and Ruth Millikan. Using the examples of gender, ethnic minorities and Buddhism she then argues that human kinds are a result of ongoing historical reproduction, chiefly due to pre-existing cultural models and social learning. Her novel argument shifts the focus away from the reductionism characteristic of research about human kinds. Instead, she argues that they are “multiply projectable” and deserving of scientific study not in spite of, but because of their role in explaining our identity, injustice and the emergence of group rights. (shrink)

Events in the US in 2020 have laid bare the reality that racism and its effects continue to take a heavy toll on the lives of Black Americans. The three articles in this issue of AJOB each provide...

Clinical ethics consultation is largely outside the scope of regulation and oversight, despite its importance. For decades, the bioethics community has been unable to reach a consensus on whether there should be accountability in this work, as there is for other clinical activities that influence the care of patients. The American Society for Bioethics and Humanities, the primary society of bioethicists and scholars in the medical humanities and the organizational home for individuals who perform CEC in the United States, has (...) initiated a two‐step quality attestation process as a means to assess clinical ethics consultants and help identify individuals who are qualified to perform this role. This article describes the process. (shrink)

The problems of racism and racially motivated violence in predominantly African American communities in the United States are complex, multifactorial, and historically rooted. While these problems are also deeply morally troubling, bioethicists have not contributed substantially to addressing them. Concern for justice has been one of the core commitments of bioethics. For this and other reasons, bioethicists should contribute to addressing these problems. We consider how bioethicists can offer meaningful contributions to the public discourse, research, teaching, training, policy development, and (...) academic scholarship in response to the alarming and persistent patterns of racism and implicit biases associated with it. To make any useful contribution, bioethicists will require preparation and should expect to play a significant role through collaborative action with others. (shrink)

According to sources both in print and at a recent meeting, evolutionary theory is currently undergoing change which some would characterize as a New Synthesis, and others as an Extended Synthesis. This article argues that the important changes involve recognizing that there are three means by which evolutionary change can be initiated and three corresponding modes of evolutionary drift. It compares the three and goes on to discuss the scale of innovation and extended or inclusive and Lamarckian inheritance. It concludes (...) from these that “new trends in evolutionary biology” are in part a new, and in part an extended evolutionary synthesis. (shrink)

Upon what kind of moral order does capitalism rest? Conversely, does the market give rise to a distinctive set of beliefs, habits, and social bonds? These questions are certainly as old as social science itself. In this review, we evaluate how today's scholarship approaches the relationship between markets and the moral order. We begin with Hirschman's characterization of the three rival views of the market as civilizing, destructive, or feeble in its effects on society. We review recent work at the (...) intersection of sociology, economics, and political economy and show that these views persist both as theories of market society and moral arguments about it. We then argue that a fourth view, which we call moralized markets, has become increasingly prominent in economic sociology. This line of research sees markets as cultural phenomena and moral projects in their own right, and seeks to study the mechanisms and techniques by which such projects are realized in practice. (shrink)

BackgroundThe increasing emphasis on research, development and innovation for health in providing solutions to the high burden of diseases in the African Region has warranted a proliferation of studies including clinical trials. This changing public health landscape requires that countries develop adequate ethics review capacities to protect and minimize risks to study participants. Therefore, this study assessed the readiness of national ethics committees to respond to challenges posed by a globalized biomedical research system which is constantly challenged by new public (...) health threats, rapid scientific and technological advancements affecting biomedical research and development, delivery and manufacture of vaccines and therapies, and health technology transfer.MethodsThis is a descriptive study, which used a questionnaire structured to elicit information on the existence of relevant national legal frameworks, mechanisms for ethical review; as well as capacity requirements for national ethics committees. The questionnaire was available in English and French and was sent to 41 of the then 46 Member States of the WHO African Region, excluding the five Lusophone Member States. Information was gathered from senior officials in ministries of health, who by virtue of their offices were considered to have expert knowledge of research ethics review systems in their respective countries.ResultsThirty three of the 41 countries responded. Thirty of respondent countries had a national ethics review committee ; 79 % of which were established by law. Twenty-five NECs had secretarial and administrative support. Over 50 % of countries with NECs indicated a need for capacity strengthening through periodic training on international guidelines for health research ethics; and allocation of funds for administrative and secretariat support.ConclusionsDespite the existing training initiatives, the Region still experiences a shortage of professionals trained in health research ethics/ethicists. Committees continue to face various capacity needs especially for evaluating clinical trials, for monitoring ongoing research, database management and for accrediting institutional ethics committees. Given the growing number of clinical trials involving human participants in the African Region, there is urgent need for supporting countries without NECs to establish them; capacity strengthening where they exist; and creation of a regional network and joint ethical review mechanisms, whose membership would be open to all NECs of the Region. (shrink)

Joint action is a growing field of research, spanning across the cognitive, behavioral, and brain sciences as well as receiving considerable attention amongst philosophers. I argue that there has been a significant oversight within this field concerning the possibility that many joint actions are driven, at least in part, by agents' social motivations rather than merely by their shared intentions. Social motivations are not directly related to the (joint) target goal of the action. Instead, when agents are mutually socially motivated (...) in joint action this is because they find acting with others rewarding in its own right. Moreover the involvement of social motivation in joint action typically enables individuals to achieve the long-term benefits associated with being part of a social bond. I argue that taking social motivations into account better prepares us for explaining a broader range of joint actions, including those that are of an antagonistic, competitive, or explorative character. Finally, I show that recognizing the importance of social motivations entails that joint actions (in general) should be understood as having the two primary functions of (1) achieving the intended target outcome of an action, and (2) attaining the benefits related to being part of a social bond. (shrink)

As pressures increase to contain growing healthcare expenditures, there is currently a prominent rise in the shift of healthcare costs to patients in the form of deductibles, co-pays, and co-insurance. Rising co-payments are part of a larger picture of increasing overall out-of-pocket healthcare expenditures. From 1990 to 2000, per capita out-of-pocket payments for healthcare reached $707 in the United States, and doubled in several European countries with universal health insurance, reaching $396 in Denmark, $290 in Germany, and $466 in Italy (...) in 2000. (shrink)

This paper aims to build a bridge between two areas of philosophical research, the structure of kinds and metaphysical modality. Our central thesis is that kinds typically involve super-explanatory properties, and that these properties are therefore metaphysically essential to natural kinds. Philosophers of science who work on kinds tend to emphasize their complexity, and are generally resistant to any suggestion that they have “essences”. The complexities are real enough, but they should not be allowed to obscure the way that kinds (...) are typically unified by certain core properties. We shall show how this unifying role offers a natural account of why certain properties are metaphysically essential to kinds. (shrink)

How can we make sense of future-looking collective responsibility? What is its moral basis and how -- under what conditions -- can we ascribe it to particular groups? I address these questions below and, in doing so, argue that in ascribing future-looking collective responsibility we need to bring claims of backward-looking (causal) responsibility together with judgments of fairness, practicality, and group identity.

Uncertainty about the acceptability of the forest industry and its practices to the citizens of Mississippi provided the impetus for a study of the attitudes and perceptions of eight constituency groups toward the forest industry in the state. This study examines attitudes and perceptions of two of those groups, loggers and two environmentalists/conservationists, and finds similarities and differences. Survey data analysis finds that all groups hold similar perceptions of themes defining the forest industry and forest industry occupations but differ concerning (...) activities the industry does or does not perform well and environmental problems associated with the forest industry. Mississippi Loggers Association members hold more positive attitudes/perceptions, similar to those of the Mississippi Wildlife Federation. Attitudes/perceptions of Mississippi 2020, a small grassroots organization, differ from Mississippi Loggers Association members in all instances and from Mississippi Wildlife Federation members on some issues. (shrink)

I argue that there is a tension between the claim that at least some kinds in the special sciences are multiply realized and the claim that the reason why kinds are prized by science is that they enter into a variety of different empirical generalizations. Nevertheless, I show that this tension ceases in the case of ‘cultural homologues’—such as specific ideologies, religions, and folk wisdom. I argue that the instances of such special science kinds do have several projectable properties in (...) common due to their shared history of reproduction, and that the social learning involved means that we should also expect these kinds to be multiply realized. (shrink)

Both Walter Sinnott-Armstrong and Baylor Johnson hold that under current circumstances, individuals lack obligations to reduce their personal contributions to greenhouse gas emissions. Johnson argues that climate change has the structure of a tragedy of the commons, and that there is no unilateral obligation to reduce emissions in a commons. Against Johnson, I articulate two rationales for an individual obligation to reduce one's greenhouse gas emissions. I first discuss moral integrity, which recommends congruence between one's actions and positions at the (...) personal and political levels. Second, I draw on a Confucian, relational conception of persons to offer a critique of the collective action/tragedy of the commons framework itself. Under the relational conception, commons problems can be reconceptualised so as to dissolve the stark contrast between the individually and the collectively rational. This perspective can inform our approach to climate change and help reconcile individual and political action to mitigate it. (shrink)

In this article I examine some of the issues involved in taking psychiatric disorders as natural kinds. I begin by introducing a permissive model of natural kind-hood that at least prima facie seems to allow psychiatric disorders to be natural kinds. The model, however, hinges on there in principle being some grounding that is shared by all members of a kind, which explain all or most of the additional shared projectible properties. This leads us to the following question: what grounding (...) do psychiatric disorders qua natural kinds have? My principal method for examining the issue is a case study of a particular psychiatric disorder: the so-called “apathetic children.” I argue that there appear to be at least two competing models that both appeal to non-organic a grounding of the disorder. However, for other psychiatric disorders, such as Alzheimer’s disease, the evidence points toward an organic explanation of the disorder. I contend that what unites psychiatric disorders is not a distinctive type of grounding that all psychiatric disorders share, but the distinctive set of determinable properties that is shared by all psychiatric disorders. (shrink)

Cet article vise à comprendre la théorie stoïcienne de la deixis afin d’expliquer l’importance accordée par les stoïciens aux pronoms démonstratifs et aux énoncés qu’ils composent, c’est-à-dire les propositions dites définitives. Nous montrons que ces propositions sont privilégiées pour des raisons à la fois ontologiques et épistémologiques en raison des propriétés sémantiques de leur sujet. Elles sont privilégiées d’un point de vue ontologique parce que la deixis grâce à laquelle leur sujet fait référence au réel crée une relation privilégiée à (...) la matière, la catégorie ontologique stoïcienne fondamentale. De plus, ces sujets requièrent que leur référent existe et soit présent et saisissable. Ces énoncés sont d’autre part privilégiés d’un point de vue épistémologique parce qu’ils sont fondamentaux dans l’acquisition de la connaissance. Nous suggérons enfin que tous les énoncés apparemment définis ne le sont pas en effet, et considérons quand et sous quelles conditions une référence déictique est réussie. (shrink)

This pioneering book demonstrates the crucial importance of Wittgenstein's philosophy of mathematics to his philosophy as a whole. Marion traces the development of Wittgenstein's thinking in the context of the mathematical and philosophical work of the times, to make coherent sense of ideas that have too often been misunderstood because they have been presented in a disjointed and incomplete way. In particular, he illuminates the work of the neglected 'transitional period' between the Tractatus and the Investigations.

We consider an infinite two-person game. The second player has a winning perfect information strategy; we show that this player has a winning strategy which depends on substantially less information. The game studied here is a variation on a game of Gale.

Family members can provide crucial support to individuals participating in clinical trials. In research on the “newest frontier” of Deep Brain Stimulation (DBS)—the use of DBS for psychiatric conditions—family member support is frequently listed as a criterion for trial enrollment. Despite the significance of family members, qualitative ethics research on DBS for psychiatric conditions has focused almost exclusively on the perspectives and experiences of DBS recipients. This qualitative study is one of the first to include both DBS recipients and their (...) family members as interview participants. Using dyadic thematic analysis—an approach that takes both the individuals and the relationship as units of analyses—this study analyzes the complex ways in which family relationships can affect DBS trial participation, and how DBS trial participation in turn influences family relationships. Based on these findings, we propose ways to improve study designs to better take family relationships into account, and better support family members in taking on the complex, essential roles that they play in DBS trials for psychiatric conditions. (shrink)

Although clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems, progress in developing standards for quality is challenging. In this article, we describe the results of a pilot project utilizing portfolios as an evaluation tool. We found that this approach is feasible and resulted in a reasonably wide distribution of scores among the 23 submitted portfolios that we evaluated. We discuss limitations and implications of these results, and suggest that this is a significant step (...) on the pathway to an eventual certification process for clinical ethics consultants. (shrink)

Attempts have been made to establish nanoethics as a new sub-discipline of applied ethics. The nature of this sub-discipline is discussed and some issues that should be subsumed under nanoethics are proposed. A distinction is made between those issue that may ensue once nanotechnology applications become available and procedural issues that should be integrated into the decision structure of the development. A second distinction relates to the central value of the ethical issue. The conditions for the ethical debate differ depending (...) on whether the value(s) in question is internal to the technological development (i.e. health and safety) or external to it (i.e. privacy, equity etc). (shrink)