When discussing the morality of gonad transplantation for procreative purposes, it can be tempting to examine the act solely qua reproductive technology. This paper, instead, compares the gonad to the kidney and evaluates the act qua organ transplantation. First, the author expounds a hierarchy of organs in relation to personal identity. Next, after considering an organ’s subjective effect on identity, the author elucidates an organ’s objective effect by ranking the powers of the soul and the goods of the human person. (...) The hierarchy of organs shows the gonad to be among the highest organs and most perfective of the human person. Because of the gonad’s highly personal nature, it cannot licitly be directed to another’s good. (shrink)

The ongoing expansion of new communication technologies is inseparably linked to the transformation of political communication. The new thinking behind communication is embedded directly in the code of popular social networks. Can a formal political party successfully implement a decentralized mode of communication based on personal connections and weak social ties, or is it against the very logic of both the hierarchical organizations and the technology itself? Our case study describes the vast spectrum of various types of behavior of political (...) actors on Twitter through computer-assisted analysis of Twitter communication in Czech Republic before the elections to the European Parliament in May 2014. The research is based on the concept of connective action, as defined by Bennett and Segerberg. Preliminary results show an emerging typology of campaign strategies, from formal and centralized campaigns on one hand to various hybrid overlaps of traditional and new forms of communication on the other. (shrink)

Generative AI programs can produce high-quality written and visual content that may be used for good or ill. We argue that a credit–blame asymmetry arises for assigning responsibility for these outputs and discuss urgent ethical and policy implications focused on large-scale language models.

Recent advances in medical and information technologies, the availability of new types of medical data, the requirement of increasing numbers of study participants, as well as difficulties in recruitment and retention, all present serious problems for traditional models of specific and informed consent to medical research. However, these advances also enable novel ways to securely share and analyse data. This paper introduces one of these advances—blockchain technologies—and argues that they can be used to share medical data in a secure and (...) auditable fashion. In addition, some aspects of consent and data collection, as well as data access management and analysis, can be automated using blockchain-based smart contracts. This paper demonstrates how blockchain technologies can be used to further all three of the bioethical principles underlying consent requirements: the autonomy of patients, by giving them much greater control over their data; beneficence, by greatly facilitating medical research efficiency and by reducing biases and opportunities for errors; and justice, by enabling patients with rare or under-researched conditions to pseudonymously aggregate their data for analysis. Finally, we coin and describe the novel concept of prosent, by which we mean the blockchain-enabled ability of all stakeholders in the research process to pseudonymously and proactively consent to data release or exchange under specific conditions, such as trial completion. (shrink)

Different ideas of the normative relevance of autonomy can give rise to profoundly different action-guiding principles in healthcare. If autonomy is seen as a value rather than as a right, it can be argued that patients’ decisions should sometimes be overruled in order to protect or promote their own autonomy. We refer to this as paternalism in the name of autonomy. In this paper, we discuss different elements of autonomy (decision-making capacity, efficiency, and authenticity) and arguments in favor of paternalism (...) for the sake of autonomy that have been proposed in the bioethical debate. We argue that if autonomy is valuable, then paternalism for the sake of autonomy may be justified. However, policies allowing paternalism in the name of autonomy may be self-defeating. (shrink)

Social networks can influence people’s behaviour and therefore it is assumed that central individuals in social networks, also called “opinion leaders”, play a key role in driving change in agricultural and food systems. I analyse the outcomes of an intervention (that encouraged Sulawesi smallholder farmers to take a specific action toward improving the health of their cocoa trees) to assess the impact of engaging opinion leaders in agricultural programs that aim to change farmers’ practices. The intervention has been implemented through (...) (a) 18 opinion leaders identified by interviews and a social network survey of 1885 cocoa farmers; and (b) 18 randomly selected farmers who were not central in local social networks. The obtained social networks and statistical data were quantitatively analysed and the results were interpreted with input from the field staff. Contrary to expectations, the highly socially central opinion leaders were not more effective in promoting the initiative in their communities. On average, randomly selected low-centrality farmers convinced almost twice as many of their peers to take the recommended action as compared to the identified opinion leaders (17.1 versus 8.6) but the variation within the random group was also significantly higher. Importantly, while the identified opinion leaders were mostly senior men, women performed better in influencing others into taking action even when their centrality in local social networks of agricultural advice was lower. I discuss the implications of the conventional selection of perceived opinion leaders as model farmers for achieving sustainable and equitable change at scale in agriculture and propose practical alternatives. (shrink)

There are three lines of argument in defence of coercive treatment of patients with mental disorders: arguments regarding (1) societal interests to protect others, (2) the patients' own health interests, and (3) patient autonomy. In this paper, we analyse these arguments in relation to an idealized case, where a person with a mental disorder claims not to want medical treatment for religious reasons. We also discuss who should decide what in situations where patients with mental disorders deny treatment on seemingly (...) rational grounds.We conclude that, in principle, coercive treatment cannot be defended for the sake of protecting others. While coercive actions can be acceptable in order to protect close family and others, medical treatment is not justified for such reasons but should be given only in the interest of patients. Coercive treatment may be required in order to promote the patient's health interests, but health interests have to waive if they go against the autonomous interests of the patient. We argue that non-autonomous patients can have reasons, rooted in their deeply-set values, to renounce compulsory institutional treatment, and that such reasons should be respected unless it can be assumed that their new predicaments have caused them to change their views. (shrink)

BackgroundInvoluntary treatment is a key issue in healthcare ethics. In this study, ethical issues relating to involuntary psychiatric treatment are investigated through interviews with Swedish psychiatrists.MethodsIn-depth interviews were conducted with eight Swedish psychiatrists, focusing on their experiences of and views on compulsory treatment. In relation to this, issues about patient autonomy were also discussed. The interviews were analysed using a descriptive qualitative approach.ResultsThe answers focus on two main aspects of compulsory treatment. Firstly, deliberations about when and why it was justifiable (...) to make a decision on involuntary treatment in a specific case. Here the cons and pros of ordering compulsory treatment were discussed, with particular emphasis on the consequences of providing treatment vs. refraining from ordering treatment. Secondly, a number of issues relating to background factors affecting decisions for or against involuntary treatment were also discussed. These included issues about the Swedish Mental Care Act, healthcare organisation and the care environment.ConclusionsInvoluntary treatment was generally seen as an unwanted exception to standard care. The respondents’ judgments about involuntary treatment were typically in line with Swedish law on the subject. However, it was also argued that the law leaves room for individual judgments when making decisions about involuntary treatment. Much of the reasoning focused on the consequences of ordering involuntary treatment, where risk of harm to the therapeutic alliance was weighed against the assumed good consequences of ensuring that patients received needed treatment. Cases concerning suicidal patients and psychotic patients who did not realise their need for care were typically held as paradigmatic examples of justified involuntary care. However, there was an ambivalence regarding the issue of suicide as it was also argued that risk of suicide in itself might not be sufficient for justified involuntary care. It was moreover argued that organisational factors sometimes led to decisions about compulsory treatment that could have been avoided, given a more patient-oriented healthcare organisation. (shrink)

In this paper I will revisit the debate over pornography by doing three things: (a) I will suggest a more sophisticated, two‐dimensional set of distinctions between positons in the debate; (b) I will then go on to attack both libertarians and the group I call “repressive feminists”; and (c) I will conclude by suggesting that by means of Hume's theory of sympathy we could support a limited form of censorship to bring women more fully into our moral and political community. (...) I turn first to the labors of definition. (shrink)

When making substituted judgments for incapacitated patients, surrogates often struggle to guess what the patient would want if they had capacity. Surrogates may also agonize over having the (sole) responsibility of making such a determination. To address such concerns, a Patient Preference Predictor (PPP) has been proposed that would use an algorithm to infer the treatment preferences of individual patients from population-level data about the known preferences of people with similar demographic characteristics. However, critics have suggested that even if such (...) a PPP were more accurate, on average, than human surrogates in identifying patient preferences, the proposed algorithm would nevertheless fail to respect the patient’s (former) autonomy since it draws on the ‘wrong’ kind of data: namely, data that are not specific to the individual patient and which therefore may not reflect their actual values, or their reasons for having the preferences they do. Taking such criticisms on board, we here propose a new approach: the Personalized Patient Preference Predictor (P4). The P4 is based on recent advances in machine learning, which allow technologies including large language models to be more cheaply and efficiently ‘fine-tuned’ on person-specific data. The P4, unlike the PPP, would be able to infer an individual patient’s preferences from material (e.g., prior treatment decisions) that is in fact specific to them. Thus, we argue, in addition to being potentially more accurate at the individual level than the previously proposed PPP, the predictions of a P4 would also more directly reflect each patient’s own reasons and values. In this article, we review recent discoveries in artificial intelligence research that suggest a P4 is technically feasible, and argue that, if it is developed and appropriately deployed, it should assuage some of the main autonomy-based concerns of critics of the original PPP. We then consider various objections to our proposal and offer some tentative replies. (shrink)

Decision-making capacity is a key concept in contemporary healthcare ethics. Previous research has mainly focused on philosophical, conceptual issues or on evaluation of different tools for assessing patients’ capacity. The aim of the present study is to investigate how the concept and its normative role are understood in Swedish psychiatric care. Of special interest for present purposes are the relationships between decisional capacity and psychiatric disorders and between health law and practical ethics.

Is synaesthesia cognitively useful? Individuals with time–space synaesthesia experience time units as idiosyncratic spatial forms, and report that these forms aid them in mentally organising their time. In the present study, we hypothesised that time–space synaesthesia would facilitate performance on a time-related cognitive task. Synaesthetes were not specifically recruited for participation; instead, likelihood of time–space synaesthesia was assessed on a continuous scale based on participants’ responses during a semi-structured interview. Participants performed a month-manipulation task, which involved naming every second month (...) or every third month in reverse-chronological order, beginning and ending with a target month. Using hierarchical multiple regression, we found that time–space synaesthesia corresponded with faster performance on both versions of the task. We propose that time–space synaesthesia may expedite the cognitive manipulation of time-based information. Our results also indicate that synaesthesia is far less unusual than widely believed. (shrink)

Drugs used to provide improvement of cognitive functioning have been shown to be effective in healthy individuals. It is sometimes assumed that the use of these drugs constitutes cheating in an academic context. We examine whether this assumption is ethically sound. Beyond providing the most up-to-date discussion of modafinil use in an academic context, this contribution includes an overview of the safety of modafinil use in greater depth than previous studies addressing the issue of cheating. Secondly, we emphasize two crucial, (...) but hitherto nearly overlooked, nuances to the issues: the potential for modafinil to decrease inequality and disadvantage in academic settings, and the fact that how modafinil is used dramatically impacts its effects on health, coercion, fairness, authenticity and effort. Finally, we explicitly defend the position that there are no qualitatively morally relevant differences between modafinil use and other enhancement modalities; any such differences are in degree,... (shrink)

Large language models (LLMs) such as ChatGPT or Google’s Bard have shown significant performance on a variety of text-based tasks, such as summarization, translation, and even the generation of new...

ABSTRACT As a classical philologist, Nietzsche was extremely familiar with the work of many ancient Greek writers. It is well known that Nietzsche made a practice of identifying with and praising ancient thinkers with whom he felt a kinship. It is worth investigating, then, whether Nietzsche's mention of Hippocrates in D signals a sustained interest in the so-called father of medicine. I argue that there is no evidence that Nietzsche paid special attention to Hippocrates or the Hippocratic corpus. Instead, Nietzsche's (...) curious allusion to Hippocrates is likely influenced in part by his reading of the Comtean positivist Émile Littré. Finally, I argue that if Nietzsche is consciously “Hippocratic” at all, he is so in virtue of the “medical posture” he adopts in D, where Nietzsche's remarks suggest his mission is to relieve humankind of the psychological suffering caused by morality. (shrink)

Down Girl is a broad, original, and far ranging analysis of what misogyny really is, how it works, its purpose, and how to fight it. The philosopher Kate Manne argues that modern society's failure to recognize women's full humanity and autonomy is not actually the problem. She argues instead that it is women's manifestations of human capacities -- autonomy, agency, political engagement -- is what engenders misogynist hostility.

For many of us, entry into motherhood involves an ambiguous visibility and intelligibility, where our acceptance into mainstream spaces as mothers entails a loss of lesbian difference. Mann explores this loss using the work of two philosophers of lesbian difference, Monique Wittig and Judith Butler. She argues that the figure of the lesbian mother is deployed on a broad cultural scale to reinvigorate and renaturaUze the myth of the happy, natural, heterosexual mother.

In The City of God , XI, 10, St Augustine claims that the divine nature is simple because ‘it is what it has’ . We may take this as a slogan for the Doctrine of Divine Simplicity , a doctrine which finds its way into orthodox medieval Christian theological speculation. Like the doctrine of God's timeless eternality, the DDS has seemed obvious and pious to many, and incoherent, misguided, and repugnant to others. Unlike the doctrine of God's timeless eternality, the (...) DDS has received very little critical attention. The DDS did not originate with Augustine, but I am not primarily concerned with its pedigree. Nor am I concerned to ask how the doctrine interacts with trinitarian speculation. I will have my hands full as it is. In Section I of this paper I shall provide a rough characterization of the DDS, indicate its complexity, and focus on a particular aspect of the doctrine which will exercise us in the remainder of the paper, namely, the thesis that the divine attributes are all identical with each other and with God. In section n I shall discuss Alvin Plantinga's recent objections to Aquinas' version of the DDS. I shall then offer a more detailed presentation of what I take to be Aquinas' version , and recast it in terms of a theory of attributes which is significantly different from Plantinga's . Although the recasting of the doctrine will enable me to rebut Plantinga's objections , it by no means solves all the problems of the DDS. In section vi I shall discuss the chief lingering problem facing a defender of the DDS. (shrink)

Are we responsible for our misdeeds in dreams? The obvious answer would seem to be ‘No’. Dreams catch us with our defences down: just those critical and discriminative abilities which are distinctive of our waking lives as responsible moral agents seem out of play when we dream; el sueño de la razón produce monstruos . Moreover, if we are responsible for our dreamt misdeeds, then parity of reasoning demands that we be praised for dreaming noble dreams. But that is absurd. (...) Moral credit should not come that easily, and so neither should moral blame. (shrink)

For some years, Matthew Meyer has labored at a comprehensive interpretation of Nietzsche’s oeuvre that understands his philosophical and literary output as a revival of a particularly Greek mode of thought. This volume represents the culmination of much, but not all, of this previous work, and it serves also as a promise of future work in the same vein. The title, Reading Nietzsche Through the Ancients, is therefore a trifle misleading: Meyer is not reading all of Nietzsche through all the (...) ancients, but only some of Nietzsche through some of them. That is all for the good, so far as I am concerned, since I am usually suspicious of ambitions to resolve Nietzsche’s debt to antiquity in a single... (shrink)

Hot spot policing is an established concept that is proven to reduce crime. It is mostly done through foot patrol or car patrols. In the present study it is tested whether helicopters can produce a deterrent policing effect to reduce the amount of vehicle arsons in Sweden on larger hot areas. Sweden tends to have elevated levels of vehicle arsons in August, with about 20% of police districts responsible for 50% of the cases. The risk narrative revolves around youth congregating (...) in public places in deprived neighborhoods to generate disturbances, and the disruption of the risk narrative tested here is based on providing deterrence through helicopter police presence. During 6 weeks in August and September of 2019 police helicopters patrolled four police districts in Sweden to attempt to prevent vehicle arsons. Our data comprise police reports of vehicle arson, and time stamped satellite data over the location for police helicopters. The evaluation considers whether there is an intention to treat effect from this project, in addition to whether there is an effect of actual helicopter presence. The study finds no significant effect of intention to treat, nor of actual dosage. (shrink)

The Durkheim Test. Remarks on Susan Leigh Star’s Boundary Objects. The article reconstructs Susan Leigh Star’s conceptual work on the notion of ‘boundary objects’. It traces the emergence of the concept, beginning with her PhD thesis and its publication as Regions of the Mind in 1989. ‘Boundary objects’ attempt to represent the distributed, multifold nature of scientific work and its mediations between different ‘social worlds’. Being addressed to several ‘communities of practice’, the term responded to questions from Distributed Artificial Intelligence (...) in Computer Science, Workplace Studies and Computer Supported Cooperative Work (CSCW), and microhistorical approaches inside the growing Science and Technology Studies. Yet the interdisciplinary character and interpretive flexibility of Star’s invention has rarely been noticed as a conceptual tool for media theory. I therefore propose to reconsider Star’s ‘Durkheim test’ for sociotechnical media practices. (shrink)

The lies about the reasons for the U.S. war against Iraq provoked no mass public outcry in the United States against the war. What is the process of justification for this war, a process that seems to need no reasons? Mann argues that the process of justification is not a process of rational deliberation but one of aesthetic self-constitution, of rebuilding a masculine national identity. Included is a feminist reading of the National Defense University document Shock and Awe.

When evaluating an innovative intervention in a randomised controlled trial , choosing an appropriate control intervention is necessary for a clinically meaningful result. An RCT reported in 2000 addressed the relative merits of two tidal volume ventilatory strategies, 6 ml/kg and 12 ml/kg , in patients with acute respiratory distress syndrome. Critics claim that the 12 ml/kg volume did not represent the clinical practice standard at that time, and that lower tidal volumes had been used in some patients prior to (...) randomisation. The trialists responded that current practice involved the use of a broad range of tidal volumes, including 12 ml/kg. Appropriate control interventions for RCTs can be ensured by: a systematic review of the relevant literature; a formal survey of expert clinicians; and publication of the proposed research protocol to solicit critical appraisal. A global survey of experts during the RCT’s design stage would have been of probative value in determining the appropriate control tidal volume. Hypothetical, but plausible, results of such a survey are presented and examined to demonstrate the value of this method. (shrink)

Over the last fifteen years, an ambitious explanatory framework has been proposed to unify explanations across biology and cognitive science. Active inference, whose most famous tenet is the free energy principle, has inspired excitement and confusion in equal measure. Here, we lay the ground for proper critical analysis of active inference, in three ways. First, we give simplified versions of its core mathematical models. Second, we outline the historical development of active inference and its relationship to other theoretical approaches. Third, (...) we describe three different kinds of claim -- labelled mathematical, empirical and general -- routinely made by proponents of the framework, and suggest dialectical links between them. Overall, we aim to increase philosophical understanding of active inference so that it may be more readily evaluated. -/- This the final submitted version of the Introduction to the Topical Collection "The Free Energy Principle: From Biology to Cognition", forthcoming in Biology & Philosophy. (shrink)

This paper aims to establish several interconnected points. First, a particular interpretation of the mathematical definition of information, known as the causal interpretation, is supported largely by misunderstandings of the engineering context from which it was taken. A better interpretation, which makes the definition and quantification of information relative to the function of its user, is outlined. The first half of the paper is given over to introducing communication theory and its competing interpretations. The second half explores three consequences of (...) the main thesis. First, a popular claim that the quantification of information in a signal is irrelevant for the meaning of that signal is exposed as fallacious. Second, a popular distinction between causal and semantic information is shown to be misleading, and I argue it should be replaced with a related distinction between natural and intentional signs. Finally, I argue that recent empirical work from microbiology and cognitive science drawing on resources of mathematical communication theory is best interpreted by the functional account. Overall, a functional approach is shown to be both theoretically and empirically well-supported. (shrink)