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

The increasing use of opioid treatment agreements has prompted debate within the medical community about ethical challenges with respect to their implementation. The focus of debate is usually on the efficacy of OTAs at reducing opioid misuse, how OTAs may undermine trust between physicians and patients and the potential coercive nature of requiring patients to sign such agreements as a condition for receiving pain care. An important consideration missing from these conversations is the potential for racial bias in the current (...) way that OTAs are incorporated into clinical practice and in the amount of physician discretion that current opioid guidelines support. While the use of OTAs has become mandatory in some states for certain classes of patients, physicians are still afforded great leeway in how these OTAs are implemented in clinical practice and how their terms should be enforced. This paper uses the guidelines provided for OTA implementation by the states of Indiana and Pennsylvania as case studies in order to argue that giving physicians certain kinds of discretion may exacerbate racial health disparities. This problem cannot simply be addressed by minimising physician discretion in general, but rather by providing mechanisms to hold physicians accountable for how they treat patients on long-term opioid therapy to ensure that such treatment is equitable. There are no data in this work. (shrink)

Fact-finding hearings may be held to determine disputed allegations of domestic violence in child contact cases in England and Wales, and can play a vital role for mothers seeking protection and autonomy from violent fathers. Drawing on the author’s empirical study, this article examines the implications for the holding of fact-finding hearings of judges’ and professionals’ understandings of domestic violence and the extent to which they perceive it to be relevant to contact. While more judges and professionals are developing their (...) understanding of domestic violence, the ambit of when and how it is considered relevant to contact has grown increasingly narrow, which suggests that many disputed allegations of domestic violence are disregarded and women and children continue to be put at risk from violent fathers. This bifurcated approach is likely to have significant implications for recent developments in this area of family law which are considered in this article. (shrink)

Recently, there has been a surge of interest in the lexicon. The demand for a fuller and more adequate understanding of lexical meaning required by developments in computational linguistics, artificial intelligence, and cognitive science has stimulated a refocused interest in linguistics, psychology, and philosophy. Different disciplines have studied lexical structure from their own vantage points, and because scholars have only intermittently communicated across disciplines, there has been little recognition that there is a common subject matter. The conference on which this (...) volume is based brought together interested thinkers across the disciplines of linguistics, philosophy, psychology, and computer science to exchange ideas, discuss a range of questions and approaches to the topic, consider alternative research strategies and methodologies, and formulate interdisciplinary hypotheses concerning lexical organization. The essay subjects discussed include: * alternative and complementary conceptions of the structure of the lexicon, * the nature of semantic relations and of polysemy, * the relation between meanings, concepts, and lexical organization, * critiques of truth-semantics and referential theories of meaning, * computational accounts of lexical information and structure, and * the advantages of thinking of the lexicon as ordered. (shrink)

ABSTRACTThe standard view in philosophy of mind is that the way to understand the difference between perception and misperception is in terms of accuracy. On this view, perception is accurate while...

What exactly is hope and how does it influence our decisions? In How We Hope, Adrienne Martin presents a novel account of hope, the motivational resources it presupposes, and its function in our practical lives. She contends that hoping for an outcome means treating certain feelings, plans, and imaginings as justified, and that hope thereby involves sophisticated reflective and conceptual capacities. Martin develops this original perspective on hope--what she calls the "incorporation analysis"--in contrast to the two dominant philosophical conceptions (...) of hope: the orthodox definition, where hoping for an outcome is simply desiring it while thinking it possible, and agent-centered views, where hoping for an outcome is setting oneself to pursue it. In exploring how hope influences our decisions, she establishes that it is not always a positive motivational force and can render us complacent. She also examines the relationship between hope and faith, both religious and secular, and identifies a previously unnoted form of hope: normative or interpersonal hope. When we place normative hope in people, we relate to them as responsible agents and aspire for them to overcome challenges arising from situation or character. Demonstrating that hope merits rigorous philosophical investigation, both in its own right and in virtue of what it reveals about the nature of human emotion and motivation, How We Hope offers an original, sustained look at a largely neglected topic in philosophy. (shrink)

I first argue that the Matrix trilogy is a Gnostic cyber-epic; I then use this interpretive lens to review the films' treatment of fundamental questions in epistemology, metaphysics, and value theory.

This article defends a theory of diffuse attention and distinguishes it from focal attention. My view is motivated by evidence from psychology and neuroscience, which suggests that we can deploy visual selective attention in at least two ways: by focusing on a small number of items, or by diffusing attention over a group of items taken as a whole. I argue that diffuse attention is selective and can be object‐based. It enables a subject to select an object to guide behavior, (...) albeit in a different way than focusing does. (shrink)

Put relationship-centered communication at the forefront of care Today, physicians face a hypercompetitive marketplace in which they must meet unique and complex patient needs as efficiently as possible. But in a culture prioritizing clinical outcomes above all, there can be a tendency to lose sight of one of the most critical aspects of providing effective care: the communication skills that build and foster physician-patient relationships. Studies have shown that good communication between doctors and patients and among all caregivers who interface (...) with patients directly results in better clinical outcomes, reduced costs, greater patient satisfaction, and lower rates of physician burnout. In Communication the Cleveland Clinic Way, Dr. Adrienne Boissy and her team tell the story of how Cleveland Clinic created and applied the R.E.D.E. to Communicate: Foundations of Healthcare program, making the world-renowned hospital system a leader in relationship-centered care. They provide a step-by-step guide for healthcare leaders and decision-makers to design, develop, and implement communication skills training in their own institutions. Learn how to: • Craft an effective, colleague-supported communication skills program to include veteran physicians, residents, and medical students • Leverage creative program design and data transparency to engage and facilitate staff physicians and advanced care providers • Identify common misperceptions and myths in healthcare communication and respond to them successfully • Cultivate a true sense of empathy—with patients and fellow caregivers alike—while maintaining professionalism In a field where difficult conversations and stressful relationships are commonplace, clinicians need a structured approach to enable them to deliver the best care possible. Communication the Cleveland Clinic Way is the blueprint for establishing a relationship-centered program that will improve patient experience, reinvigorate doctors’ passion for their work, and elevate any organization. (shrink)

In cases of identity crowding, a subject consciously sees items in a figure, even though they are presented too closely together for her to shift attention to each item. Block uses such cases to challenge the view that attention is necessary for consciousness. I argue that in identity crowding cases, subjects really do attend to the items. Specifically, they attend to the figure as a global object that contains the individual items as parts. To support this view, I provide evidence (...) that attention can be directed to a global object or a local object. My response helps to defend the view that attention is necessary for conscious perception. (shrink)

The thesis of this paper is that Platonic Forms are angels. I make this identification by claiming that Platonic Forms have the characteristics of angels, in particular, that Platonic Forms are alive. I offer four arguments for this claim. First, it seems that engaging in self-directed action is a sufficient condition for being alive. The Forms are, as teleological activities, self-directed actions. Second, bodies receive their being from their Forms, and some bodies are essentially alive. Third, in the Good, all (...) the types of goodness, including life, are identical. The Forms are appearances of the Good. Fourth, since the Good imparts as much goodness as it can, the Forms are alive unless there is some bar to their being alive. There are good reasons to think that there is no such bar. I then show that ethical vices do not give body to human form, but give body to other forms—those that are evil angels. Lastly, I provide a survey of the relationships that various religious traditions posit between ethical vice and the demonic. (shrink)

People with disabilities use more medical care and see health professionals more often than do those of the same age, ethnic group, or economic class who do not have impairments. An indisputable medical goal is.

This chapter offers an overview and analysis of policing, the area of criminal justice associated primarily with law enforcement. The study of policing spans a variety of disciplines, including criminology, law, philosophy, politics, and psychology, among other fields. Although research on policing is broad in scope, it has become an especially notable area of study in contemporary legal and social philosophy given recent police controversies.

Attention seems to raise a problem for pure representationalism, the view that phenomenal content supervenes on representational content. The problem is that shifts of attention sometimes seem to bring about a change in phenomenal content without a change in representational content. I argue that the representationalist can meet this challenge, but that doing so requires a new view of the representational content of perception. On this new view, the representational content of perception is always relative to a way of attending. (...) I call this the attention-indexed view of perceptual content. (shrink)

Ce bref texte en forme de manifeste rappelle que les mouvements de transformation sociale dirigés vers davantage de justice sont d’autant plus forts que leurs membres reconnaissent avec lucidité et compassion leurs propres implications dans les mécanismes générateurs de violences. Plutôt que des gestes de condamnation et d’annulation ( cancel ), ce sont donc des attitudes d’écoute, de soutien et de solidarité active qui sont requis.

It is gratifying that thoughtful philosophers and bioethicists like Mahowald and Nelson are continuing to address the objections to prenatal testing that have been made by disability scholars and advocates. But it is frustrating to see those objections presented in ways that reflect the doubts of those who reject them more than the intentions of those who make them, in ways that make those objections appear censorious toward pregnant women and prospective parents or naïve about nonverbal expression. We recognize that (...) disability critics share the responsibility for these misunderstandings, that their objections to prenatal disability testing have not always been made as clearly or consistently as they might have been. We therefore welcome this opportunity for clarification and rebuttal. Briefly, we will argue against Mahowald that it is not apparent how prospective parents could have a duty to potential offspring requiring them to prevent the birth of any child expected to have a life worth living. And we will remind Nelson that our primary concern is with the perpetuation of stigma; that even if any reason for abortion can be framed in terms of a trait of the fetus to be aborted, only certain reasons for abortion are based on the rejection of future children because of stigmatized traits. (shrink)

In this paper, we critically appraise institutions for people with disabilities, from residential facilities to outpatient clinics to social organizations. While recognizing that a just and inclusive society would reject virtually all segregated institutional arrangements, we argue that in contemporary American society, some people with disabilities may have needs that at this time can best be met by institutional arrangements. We propose ways of reforming institutions to make them less isolating, coercive, and stigmatizing, and to provide forms of social support (...) the larger society denies many people with disabilities. Although these reforms far fall far short of abolition, they draw heavily on the work of disability scholars and advocates who call for the complete replacement of institutional arrangements with systems of supported living. The consideration of non-ideal-solutions is useful not only in reforming existing institutional arrangements, but in bringing disability scholarship and advocacy to bear on bioethics, which has paid little attention to institutions for people with disabilities. We intend this paper to redress the neglect within mainstream bioethics of the complex ethical problems posed by institutions. (shrink)

Dans cette réflexion surgie des premières expériences de la pandémie du Covid-19, l’autrice met en écho nos peurs et nos réactions face aux dangers de la maladie et face aux actes de violence. Les condamnations sommaires et instantanées auxquelles les militant·es se livrent sur les réseaux sociaux reproduisent partiellement des dynamiques de lynchage dont il faut apprendre à davantage se méfier. Avec la distance de l’abstentiel, il est parfois plus facile de dénoncer ( call-out ) les mauvais comportements, que d’interpeler (...) et d’inclure ( call-in ) celleux qui ont fait du mal. Comment croire les survivant·es tout en restant abolitionnistes? Comment croire les survivant·es tout en pratiquant une justice transformatrice? (shrink)

This article addresses an issue overlooked in most of the literature on judicial review: the legitimacy of judicial review of a constitution's federal and structural provisions. Debates about the legitimacy of judicial review—at least as conducted throughout the Commonwealth—are usually focussed on rights. These debates appear to assume that the power of courts like the Australian High Court and the Canadian Supreme Court to interpret and enforce federal and structural provisions is unproblematic. This article tests that assumption and concludes that (...) those who hold democracy-based objections to constitutional rights should seriously reconsider, and perhaps oppose, federal and structural judicial review as well. (shrink)

This illustrated tale introduces children to the wondrous teachings from the Muslim theologian and mystic al-Ghazali (1058–1111CE) This enchanting tale illustrates how that the human heart is like a rusty mirror which, when polished through beautiful doings, is able to reflect the real essence of all things. In addition to this story is a poem by the renowned poet, Coleman Barks. Both draw on the same account found in Ghazali's The Marvels of the Heart, Book XXI, of his magnum opus,The (...) Revival of Religious Sciences. (shrink)

Over the last two decades, legal scholarship has been catching up with the more than century old calls by black Americans for reparations.1 Tax scholar Boris Bittker (in)famously launched the viability of black reparations into legal scholarship with his now classic monograph, The Case for Black Reparations.2 However, it would take more than twenty years for mainstream legal scholarship to take up the robust and wide-ranging set of questions raised by the possibility of reparations for American slavery.3 In the late (...) 1990s private law scholars leapt into the debate, discussing unjust enrichment and torts-based models of black reparations.4 While these scholars made a variety of distinct arguments, collectively, their model rested on the contention that America had wrongfully expropriated the labor of generations of enslaved African Americans and the result had been systemic unjust enrichment, or a species of mass torts. Grounded in various conceptions of corrective justice, these models conceive black reparations as a set of claims that would be litigated through the courts. Over the ensuing two decades, the private law model has become somewhat of an outlier in reparations discussions, largely set aside in favor of broader, more explicitly political approaches. (shrink)

I argue for adopting a conception of obligation that is broader than the conception commonly adopted by moral philosophers. According to this broader conception, the crucial marks of an obligatory action are, first, that the reasons for the obliged party to perform the action include an exclusionary reason and, second, that the obliged party is the appropriate target of blaming reactive attitudes, if they inexcusably fail to perform the obligatory action. An obligation is directed if the exclusionary reason depends on (...) the relationship between the obliged person and the person to whom they owe the obligatory action, and the latter person is positioned to personally blame the obligated person for inexcusably failing to perform the obligatory action. Some direc- ted obligations are not owed as a matter of right, and the person to whom the obligatory action is owed is the only person positioned to blame nonperformance. Other directed obligations are owed as a matter of right, and people who are not part of the relationship grounding the obligation nevertheless are also positioned to (impersonally) blame non-performance. Only the rights-based form of directed obligation has received signifi- cant attention from moral philosophers, yet the former—which is at the heart of what I call “personal bonds”—is a pervasive and significant theme of our ordinary interpersonal lives. (shrink)

Science and mathematics continually change in their tools, methods, and concepts. Many of these changes are not just modifications but progress---steps to be admired. But what constitutes progress? This dissertation addresses one central source of intellectual advancement in both disciplines: reformulating a problem-solving plan into a new, logically compatible one. For short, I call these cases of compatible problem-solving plans "reformulations." Two aspects of reformulations are puzzling. First, reformulating is often unnecessary. Given that we could already solve a problem using (...) an older formulation, what do we gain by reformulating? Second, some reformulations are genuinely trivial or insignificant. Merely replacing one symbol with another does not lead to intellectual progress. What distinguishes significant reformulations from trivial ones? According to what I call "conceptualism" (or "conceptual empiricism"), reformulations are intellectually significant when they provide a different plan for solving problems. Significant reformulations provide inferentially different routes to the same solution. In contrast, trivial reformulations provide exactly the same problem-solving plans, and hence they do not change our understanding. This answers the second question about what distinguishes trivial from significant reformulations. However, the first question remains: what makes a new way of solving an old problem valuable? Here, a bevy of practical considerations come to mind: one formulation might be faster, less complicated, or use more familiar concepts. According to "instrumentalism," these practical benefits are all there is to reformulating. Some reformulations are simply more instrumentally valuable for meeting the aims of science than others. At another extreme, "fundamentalism" contends that a reformulation is valuable when it provides a more fundamental description of reality. According to this view, some reformulations directly contribute to the metaphysical aim of carving reality at its joints. Conceptualism develops a middle ground between instrumentalism and fundamentalism, preserving their benefits without their costs. I argue that the epistemic value of significant reformulations does not reduce to either practical or metaphysical value. Reformulations are valuable because they are a constitutive part of problem-solving. Both science and mathematics aim at solving all possible problems within their respective domains. Meeting this aim requires being able to plan for any possible problem-solving context, and this requires reformulating. By reformulating, we clarify what we need to know to solve problems. Still, one might wonder whether the value of reformulations requires underlying differences in explanatory power. According to "explanationism," a reformulation is valuable only when it provides a better explanation. Explanationism stands as a rival middle ground position to my own. However, it faces numerous counterexamples. In many cases, two reformulations provide the same explanation while nonetheless providing different ways of understanding a phenomenon. Hence, reformulating can be valuable even when neither formulation is more explanatory. Methodologically, I draw on a variety of case studies to support my account of reformulation. These range from classical mechanics to quantum chemistry, along with examples from mathematics. Symmetry arguments provide a paradigmatic example: the mathematics of symmetry groups radically recasts quantum mechanics and quantum chemistry. Nevertheless, elementary approaches exist that eschew this additional mathematical apparatus, solving problems in a more tedious but less mathematically-demanding manner. Further examples include reformulations of quantum field theory, Arabic vs. Roman numerals, and Fermat's little theorem in number theory. In each case, my account identifies how reformulations change and improve our understanding of science and mathematics. (shrink)