Background Big data and AI applications now play a major role in many health contexts. Much research has already been conducted on ethical and social challenges associated with these technologies. Likewise, there are already some studies that investigate empirically which values and attitudes play a role in connection with their design and implementation. What is still in its infancy, however, is the comparative investigation of the perspectives of different stakeholders. Methods To explore this issue in a multi-faceted manner, we conducted (...) semi-structured interviews as well as focus group discussions with patients and clinicians. These empirical methods were used to gather interviewee’s views on the opportunities and challenges of medical AI and other data-intensive applications. Results Different clinician and patient groups are exposed to medical AI to differing degrees. Interviewees expect and demand that the purposes of data processing accord with patient preferences, and that data are put to effective use to generate social value. One central result is the shared tendency of clinicians and patients to maintain individualistic ascriptions of responsibility for clinical outcomes. Conclusions Medical AI and the proliferation of data with import for health-related inferences shape and partially reconfigure stakeholder expectations of how these technologies relate to the decision-making of human agents. Intuitions about individual responsibility for clinical outcomes could eventually be disrupted by the increasing sophistication of data-intensive and AI-driven clinical tools. Besides individual responsibility, systemic governance will be key to promote alignment with stakeholder expectations in AI-driven and data-intensive health settings. (shrink)

ZusammenfassungDerzeit gibt es in Österreich kein in allen Bundesländern einheitlich etabliertes Betreuungsmodell eines „Heimarztes“ für Pflegeheime. Im Bundesland Wien werden seit mehr als 100 Jahren chronisch Kranke und hochgradig pflegebedürftige Menschen in den städtischen Pflegeeinrichtungen und in einigen Institutionen geistlicher Träger rund um die Uhr von angestellten geriatrisch versierten ÄrztInnen betreut. Die Rechtsform dieser Häuser entspricht prinzipiell der einer „Pflegeanstalt für Chronisch Kranke“ nach dem Österreichischen Krankenanstaltengesetz. Aber auch andere Träger in Wien und Niederösterreich beschäftigen angestellte ÄrztInnen an Bettenstationen von (...) Pflege- und Wohnheimen. Der Bedarf nach einer kontinuierlichen, fachlich spezialisierten ärztlichen Betreuung ergibt sich vor allem aus der Notwendigkeit der Therapie psychiatrischer Erkrankungen im hohen Alter mit Psychopharmaka, der komplexen Multimorbidität und Polypharmazie, sowie aus dem Bedarf nach rehabilitativen Maßnahmen bzw. palliativer Begleitung am Lebensende. Mit dieser Aufgabenstellung sind geriatrisch nicht adäquat ausgebildete bzw. nicht in den Pflegeheimen integrierte ÄrztInnen häufig überfordert. Die Konsequenzen davon sind häufige Spitalseinweisungen bzw. suboptimale ärztliche Betreuung. Als notwendige Maßnahmen zur Qualitätssicherung in geriatrischen Pflegeeinrichtungen ist daher bundesweit die Implementierung von qualifizierten HeimärztInnen nach niederländischem Vorbild zu fordern. (shrink)

The book presents the first comprehensive survey of limits of the intentional control of action from an interdisciplinary perspective. It brings together leading scholars from philosophy, psychology, and the law to elucidate this theoretically and practically important topic from a variety of theoretical and disciplinary approaches. It provides reflections on conceptual foundations as well as a wealth of empirical data and will be a valuable resource for students and researchers alike. Among the authors: Clancy Blair, Todd S. Braver, Michael W. (...) Cole, Anika Fäsche, Maayan Davidov, Peter Gollwitzer, Kai Robin Grzyb, Tobias Heikamp, Gabriele Oettingen, Rachel McKinnon, Nachschon Meiran, Hans Christian Röhl, Michael Schmitz, John R. Searle, Gottfried Seebaß, Gisela Trommsdorff, Felix Thiede, J. Lukas Thürmer, Frank Wieber. (shrink)

This white paper outlines the plans of the History Philosophy Culture Working Group of the Next Generation Event Horizon Telescope Collaboration.

Berkeley’s likeness principle is the claim that “an idea can be like nothing but an idea”. The likeness principle is intended to undermine representationalism: the view (that Berkeley attributes to thinkers like Descartes and Locke) that all human knowledge is mediated by ideas in the mind which represent material objects. Yet, Berkeley appears to leave the likeness principle unargued for. This has led to several attempts to explain why Berkeley accepts it. In contrast to ‘metaphysical’ and ‘epistemological’ interpretations available in (...) the literature, in this paper I defend a ‘conceptual’ interpretation. I argue that Berkeley accepts the likeness principle on the basis of (i) his commitment to the transparency of ideas, and (ii) his account of resemblance which he sets out in his works on vision. Thus, I provide an explanation for Berkeley’s reasons for accepting the likeness principle which, appropriately, focuses on his views concerning ideas and likeness. (shrink)

This paper provides a philosophical evaluation of the concept of handedness prevalent but largely unspoken in the scientific literature. This literature defines handedness as the preference or ability to use one hand rather than the other across a range of common activities. Using the philosophical discipline of phenomenology, I articulate and critique this conceptualization of handedness. Phenomenology shows defining a concept of handedness by focusing on hand use leads to a right hand biased concept. I argue further that a phenomenological (...) model based in spatial orientation rather than hand use provides a more inclusive concept of handedness. (shrink)

Margaret Macdonald was at the institutional heart of analytic philosophy in Britain in the mid-twentieth century. Yet, her views on the nature of philosophical theories diverge quite considerably from those of many of her contemporaries. In this paper, I focus on her 1953 article ‘Linguistic Philosophy and Perception’, a provocative paper in which Macdonald argues that the value of philosophical theories is more akin to that of poetry or art than science or mathematics. I do so for two reasons. First, (...) because it reveals just how far Macdonald’s meta- philosophical views diverged from those of many of her contemporaries. Second, because the discussion in LPP pre-empts recent literature on the nature of philosophical inquiry and the efficacy of philosophical arguments. Indeed, Macdonald’s paper is just as likely to provoke discussion today as it was in the 1950s. (shrink)

It was a little over ten years ago, 1967–8, that H. D. Lewis delivered the first series of Gifford lectures, The Elusive Mind, in the University of Edinburgh. It was my privilege that year to be an auditor in the Seminar at King's College that Professor Lewis was conducting with his students in the area of this topic. I had already read the works in which, in the midst of neo-orthodox and existentialist religious movements, he had devoted himself to critical (...) valuation of those doctrines - witness his Morals and the New Theology, and Morals and Revelation. This earlier work prepared for a comprehensive interpretation of religious experience in his book in 1960: Our Experience of God. (shrink)

Many health care decisions depend not only upon medical facts, but also on value judgments—patient goals and preferences. Until recent decades, patients relied on doctors to tell them what to do. Then ethicists and others convinced clinicians to adopt a paradigm shift in medical practice, to recognize patient autonomy, by orienting decision making toward the unique goals of individual patients. Unfortunately, current medical practice often falls short of empowering patients. In this article, we reflect on whether the current state of (...) medical decision making effectively promotes patients' health care goals. We base our reflections, in part, on research in which we observed physicians making earnest efforts to partner with patients in making treatment decisions, but still struggling to empower patients—failing to communicate clearly to patients about decision-relevant information, overwhelming patients with irrelevant information, overlooking when patients' emotions made it hard to engage in choices, and making recommendations before discussing patients' goals. (shrink)

We suggest that the emerging field of the conservation humanities can play a valuable role in biodiversity protection in Papua New Guinea (PNG), where most land remains under collective customary clan ownership. As a first step to mobilising this scholarly field in PNG and to support capacity development for PNG humanities academics, we conducted a landscape review of PNG humanities teaching and research relating to biodiversity conservation and customary land rights. We conducted a systematic literature review, a PNG teaching programme (...) review, and a series of online workshops between the authors (10 PNG-based, 7 UK-based). We found a small but notable amount of PNG research and teaching focused on biodiversity conservation or customary land rights. This included explicit discussion of these topics in 8 of 156 PNG-authored humanities texts published 2010-2020 and related teaching content in the curricula of several different humanities-based programmes. We discuss current barriers to PNG academic development. The growth of fully fledged in-country conservation humanities will require a joint collaborative effort by PNG researchers, who are best placed to carry out such work, and researchers from abroad who can access resources to support the process. (shrink)

In their article, “Supported Decision Making with People at the Margins of Autonomy,” Peterson, Karlawish, and Largent point to the fact that the concept of ‘supported decision-making’ has recently...

Philosophy and Phenomenological Research, EarlyView.

In the past few decades, scholars have offered positive, normative, and most recently, interpretive theories of contract law. These theories have proceeded primarily from deontological and consequentialist premises. In A Theory of Contract Law: Empirical Understandings and Moral Psychology, Professor Peter A. Alces confronts the leading interpretive theories of contract and demonstrates their interpretive doctrinal failures. Professor Alces presents the leading canonical cases that inform the extant theories of Contract law in both their historical and transactional contexts and, argues (...) that moral psychology provides a better explanation for the contract doctrine than do alternative comprehensive interpretive approaches. (shrink)

This collection focuses on questions that arise when morality is considered from the perspective of recent work on rational choice and evolution. Linking questions like "Is it rational to be moral?" to the evolution of cooperation in "The Prisoners Dilemma," the book brings together new work using models from game theory, evolutionary biology, and cognitive science, as well as from philosophical analysis. Among the contributors are leading figures in these fields, including David Gauthier, Paul M. Churchland, Brian Skyrms, Ronald de (...) Sousa, and Elliot Sober. (shrink)

In the last few years, the U.S. health care system has seemingly been gripped by “back to the nineties” fever. But there is a notable change in professional debates about how to better control health care costs. Discussion of health care rationing, which was hotly debated in the nineties, has become much more muted.Is health care rationing passé? I contend that debates about health care rationing have waned not because the need to ration has dwindled nor because ethical debates about (...) how or whether to ration have been resolved. They have declined because the word “rationing,” and unrelated concepts such as cost‐effectiveness analysis, have been replaced by terms—“parsimony,” “value,” and “CER”—that are not burdened by emotional and historical baggage.Sometimes the best way to promote healthy moral debate is to turn to new words that don't carry the burden of past debates. (shrink)

There is presently a debate between Subjectivists and Objectivists about moral wrongness. Subjectivism is the view that the moral status of our actions, whether they are morally wrong or not, is grounded in our subjective circumstances – either our beliefs about, or our evidence concerning, the world around us. Objectivism, on the other hand, is the view that the moral status of our actions is grounded in our objective circumstances – all those facts other than those which comprise our subjective (...) circumstances. A third view, Ecumenism, has it that the moral status of our actions is grounded both in our subjective and our objective circumstances. After outlining and evaluating the various arguments both against Subjectivism and against Objectivism, this Element offers a tentative defense of Objectivism about moral wrongness. (shrink)

Social referencing informs and regulates one’s relation with the environment as a function of the perceived appraisals of social partners. Increased emphasis on relational and social contexts in the study of emotion makes this interpersonal process particularly relevant to the field. However, theoretical conceptualizations and empirical operationalizations of social referencing are disjointed across domains and populations of study. This article seeks to unite and refine the study of this construct by providing a clear and comprehensive definition of social referencing. Our (...) perspective presents social referencing and social appraisal as coterminous processes and emphasizes the importance of a relational and interpersonal approach to the study of emotion. We conclude by outlining possible lines of research on this construct. (shrink)

V.1 Re-establishing an initial union among philosophy, science, and wisdom by recovering our understanding of philosophy, science : how philosophy, science, is, and always has been, chiefly a study of the one and the many -- v.2. An introduction to ragamuffin Thomism.

Numbers Skeptics deny that when faced with a choice between saving some innocent people from harm and saving a larger number of different, though equally innocent, people from suffering a similar harm you ought to save the larger number. In this article, I aim to put pressure on Numbers Skepticism.

ABSTRACT Is what we’re morally permitted to do grounded in our subjective situation? Subjectivists maintain that it is. Objectivists deny this. I shall offer two arguments for Objectivism about moral permissibility.

In physics, the temporal dimension has units of infinitesimally brief duration. Given this, how is it possible to perceive things, such as motion, music, and vibrotactile stimulation, that involve extension across many units of time? To address this problem, it is proposed that there is what is termed an “information construct of happening” (ICOH), a simultaneous representation of recent, temporally differentiated perceptual information on the millisecond time scale. The main features of the ICOH are (i) time marking, semantic labeling of (...) all information in the ICOH with ordinal temporal information and distance from what is informationally identified as the present moment, (ii) vector informational features that specify kind, direction, and rate of change for every feature in a percept, and (iii) connectives, information relating vector informational features at adjacent temporal locations in the ICOH. The ICOH integrates products of perceptual processing with recent historical information in sensory memory on the subsecond time scale. Perceptual information about happening in informational sensory memory is encoded in semantic form that preserves connected semantic trails of vector and timing information. The basic properties of the ICOH must be supported by a general and widespread timing mechanism that generates ordinal and interval timing information and it is suggested that state‐dependent networks may suffice for that purpose. Happening, therefore, is perceived at a moment and is constituted by an information structure of connected recent historical information. (shrink)

There is a moral phenomenon of “Secondary Permissibility” in which an otherwise morally impermissible option is made morally permissible by the presence of another option. In this paper I explain how this phenomenon works and argue that understanding how it works suggests a new model for the structure of the ethics of harming.

ABSTRACT Is what we’re morally permitted to do grounded in our subjective situation? Subjectivists maintain that it is. Objectivists deny this. I shall offer two arguments for Objectivism about moral permissibility.

In this paper I sketch an account of moral blame and blameworthiness. I begin by clarifying what I take blame to be and explaining how blameworthiness is to be analyzed in terms of it. I then consider different accounts of the conditions of blameworthiness and, in the end, settle on one according to which a person is blameworthy for φ-ing just in case, in φ-ing, she violates one of a particular class of moral requirements governing the attitudes we bear, and (...) our mental orientation, toward people and other objects of significant moral worth. These requirements embody the moral stricture that we accord to these others a sufficient level of respect, one that their moral worth demands. This is a familiar theme which has its roots in P. F. Strawson’s pioneering views on moral responsibility. My development of it leads me to the conclusion that acting wrongly is not a condition of blameworthiness: violating a moral requirement to perform, or refrain from performing, an action is neither necessary nor sufficient for being blameworthy. All we are ever blameworthy for, I will argue, are certain aspects of our mental bearing toward others. We can be said to be blameworthy for our actions only derivatively, in the sense that those actions are the natural manifestations of the things for which we are strictly speaking blameworthy. (shrink)

Sometimes doing what’s right depends on anticipating how people will react when you do the right thing. Consider two aspects of challenge trial payments discussed by Lynch and colleagues. Th...

This collective volume offers the radically new thesis that, generically-considered, philosophy and science are identical and great because they are mainly psychological forms of wondering about organizational formation and operation, forms of behavioral organizational and leadership psychology.

Through extensive textual analysis, this book concludes that the prevailing opinion about the nature of modern and contemporary philosophy is wrong. It maintains that almost all modern and contemporary philosophy is deconstructed, secularized, Augustinian theology, not philosophy. The work is divided into eight chapters, a guest Foreword by Herbert I. London notes, bibliography, and an index. Chapter 1 considers Cartesian thought, Hobbes, and Newton. Chapter 2 examines Locke, Berkeley, and Hume. Chapter 3 investigates Lessing and Rousseau. Chapters 4 and 5 (...) treat Kant. Chapters 6 and 7 deal with Hegel. Chapter 8 concludes that a lack of philosophical and historical experience coupled with a widespread inability to read philosophical texts according to the intention of the author causes us to mistake secularized theology for philosophy and is a main cause for the decline of contemporary universities. (shrink)

Simple Heuristics That Make Us Smart invites readers to embark on a new journey into a land of rationality that differs from the familiar territory of cognitive science and economics. Traditional views of rationality tend to see decision makers as possessing superhuman powers of reason, limitless knowledge, and all of eternity in which to ponder choices. To understand decisions in the real world, we need a different, more psychologically plausible notion of rationality, and this book provides it. It is about (...) fast and frugal heuristics--simple rules for making decisions when time is pressing and deep thought an unaffordable luxury. These heuristics can enable both living organisms and artificial systems to make smart choices, classifications, and predictions by employing bounded rationality. But when and how can such fast and frugal heuristics work? Can judgments based simply on one good reason be as accurate as those based on many reasons? Could less knowledge even lead to systematically better predictions than more knowledge? Simple Heuristics explores these questions, developing computational models of heuristics and testing them through experiments and analyses. It shows how fast and frugal heuristics can produce adaptive decisions in situations as varied as choosing a mate, dividing resources among offspring, predicting high school drop out rates, and playing the stock market. As an interdisciplinary work that is both useful and engaging, this book will appeal to a wide audience. It is ideal for researchers in cognitive psychology, evolutionary psychology, and cognitive science, as well as in economics and artificial intelligence. It will also inspire anyone interested in simply making good decisions. (shrink)

“Know thyself!” This dictum in the Upanishads is also that of the Greeks 2000 years later. But what is meant by “know” and by “self” is different. The Biblical counsel, “Know thyself as created in the image of God,” also reminds us that man’s conception of himself is influenced by his conception of his relation to his ultimate environment. In fundamental terms, there is no East and West when reflective men ask: What is the essence of man? I cannot in (...) this paper pay adequate respect to certain historic approaches to the answer, but they are in mind as I develop a personalistic, temporalistic view of man. (shrink)

Normative ethical theories owe us an account of how to evaluate decisions under risk and uncertainty. Deontologists seem at a disadvantage here: our best decision theories seem tailor-made for consequentialism. For example, decision theory enjoins us to always perform our best option; deontology is more permissive. In this paper, we discuss and defend the idea that, when some pro-tanto wrongful act is all-things considered permissible, because it is a ‘lesser evil’, it is often merely permissible, by the lights of deontology. (...) We show that this raises new problems for deontological decision theory, and we show that to resolve them, we need to take a more innovative approach to morally evaluating decision-making under risk and uncertainty. (shrink)

Objective Moral distress is a complex phenomenon experienced by healthcare professionals. This study examined the relationships between key dimensions of Organizational Culture in Healthcare (OCHC)—perceived psychological safety, ethical climate, patient safety—and healthcare professionals’ perception of moral distress.Design Cross-sectional surveySetting Pediatric and adult critical care medicine, and adult hospital medicine healthcare professionals in the United States.Participants Physicians (n = 260), nurses (n = 256), and advanced practice providers (n = 110) participated in the study.Main outcome measures Three dimensions of OCHC were (...) measured using validated questionnaires: Olson’s Hospital Ethical Climate Survey, Agency for Healthcare Research and Quality’s Patient Safety Culture Survey, and Edmondson’s Team Psychological Safety Survey. The perception of moral distress was measured using the Moral Distress Amidst a Pandemic Survey. The hypothesized relationships between various dimensions were tested with structural equation modeling (SEM).Results Adequate model fit was achieved in the SEM: a root-mean-square error of approximation =0.072 (90% CI 0.069 to 0.075), standardized root mean square residual = 0.056, and comparative fit index =0.926. Perceived psychological safety (β= −0.357, p <.001) and patient safety culture (β = −0.428, p<.001) were negatively related to moral distress experience. There was no significant association between ethical climate and moral distress (β = 0.106, p = 0.319). Ethical Climate, however, was highly correlated with Patient Safety Culture (factor correlation= 0.82).Conclusions We used structural equation model to test a theoretical model of multi-dimensional organizational culture and healthcare climate (OCHC) and moral distress.Significant associations were found, supporting mitigating strategies to optimize psychological safety and patient safety culture to address moral distress among healthcare professionals. Future initiatives and studies should account for key dimensions of OCHC with multi-pronged targets to preserve the moral well-being of individuals, teams, and organizations. (shrink)

This book challenges the presupposition among professional philosophers that René Descartes is the Father of Modern Philosophy. It demonstrates by intensive textual analysis of Descartes's _Discourse_ and _Meditations_ that he inaugurated a new type of sophistry rather than a new way of conducting philosophy. Transcendental Sophistry is a synthesis of Renaissance humanism and Christian theology, especially the theology of creation. This striking re-evaluation of the achievement of Descartes opens the history of Western philosophy to radical reinterpretation.

Peter A. Bertocci; XI—Descartes and Marcel on the Person and his Body: A Critique, Proceedings of the Aristotelian Society, Volume 68, Issue 1, 1 June 1968, Pag.

ABSTRACT Mother‐to‐child transmission (MTCT) of HIV represents a particularly dramatic aspect of the HIV epidemic with an estimated 600,000 newborns infected yearly, 90% of them living in sub‐Saharan Africa. Since the beginning of the HIV epidemic, an estimated 5.1 million children worldwide have been infected with HIV. MTCT is responsible for 90% of these infections. Two‐thirds of the MTCT are believed to occur during pregnancy and delivery, and about one‐third through breastfeeding. As the number of women of child bearing age (...) infected with HIV rises, so does the number of infected children. It is apparent that voluntary testing in Botswana has made some valuable inroads in decreasing perinatal HIV transmission, but the statistics showing the increased rate of HIV infection among women 15–24 years of age are not very promising. After reviewing all the pertinent scientific data it is clear that mandatory HIV testing of all pregnant women in conjunction with the implementation of a full package of interventions would save thousands of lives – mothers, newborns and others who could be infected as a result of these women not being aware of their HIV status. If the protection and preservation of human life is a priority in Botswana, then it is time to allow for mandatory HIV testing of all pregnant women, before it is too late for those who are the most vulnerable. To do less would be medically inappropriate and ethically irresponsible. (shrink)

Through a radical reinterpretation of classical philosophy as an organizational psychology, The Moral Psychology of St. Thomas: An Introduction to Ragamuffin Ethics just as radically reinterprets St. Thomas Aquinas's moral teaching to be a behavioristic psychology chiefly designed to synthesize right reason and right pleasure to help a person excel at living life as a whole. In the process of so doing, this work demonstrates how the skill of prudential living is a necessary condition for becoming a grand master of (...) leadership in any and every profession. (shrink)

The Mind Argument is an argument for the incompatibility of indeterminism and anyone's having a choice about anything that happens. Peter van Inwagen rejects the Mind Argument not because he is able to point out the flaw in it, but because he accepts both that determinism is incompatible with anyone's having a choice about anything that happens and that it is possible for someone to have a choice about something that happens. In this paper I first diagnose and clear (...) up a confusion in recent discussions of the Mind Argument and then go on to show why it is a bad argument. (shrink)