Machine learning-driven clinical decision support systems (ML-CDSSs) seem impressively promising for future routine and emergency care. However, reflection on their clinical implementation reveals a wide array of ethical challenges. The preferences, concerns and expectations of professional stakeholders remain largely unexplored. Empirical research, however, may help to clarify the conceptual debate and its aspects in terms of their relevance for clinical practice. This study explores, from an ethical point of view, future healthcare professionals’ attitudes to potential changes of responsibility and decision-making (...) authority when using ML-CDSS. Twenty-seven semistructured interviews were conducted with German medical students and nursing trainees. The data were analysed based on qualitative content analysis according to Kuckartz. Interviewees’ reflections are presented under three themes the interviewees describe as closely related: (self-)attribution of responsibility, decision-making authority and need of (professional) experience. The results illustrate the conceptual interconnectedness of professional responsibility and its structural and epistemic preconditions to be able to fulfil clinicians’ responsibility in a meaningful manner. The study also sheds light on the four relata of responsibility understood as a relational concept. The article closes with concrete suggestions for the ethically sound clinical implementation of ML-CDSS. (shrink)

The SARS-CoV-2 pandemic has highlighted the interdependency of healthcare systems and research organizations on manufacturers and suppliers of personnel protective equipment and the need for well-trained personnel who can react quickly to changing working conditions. Reports on challenges faced by research laboratory workers are rare in contrast to the lived experience of hospital health care workers. We report on experiences gained by RLWs who significantly contributed to combating the pandemic under particularly challenging conditions due to increased workload, sickness and interrupted (...) PPE supply chains. RLWs perform a broad spectrum of work with SARS-CoV-2 such as autopsies, establishment of virus cultures and infection models, development and verification of diagnostics, performance of virus inactivation assays to investigate various antiviral agents including vaccines and evaluation of decontamination technologies in high containment biological laboratories. Performance of autopsies and laboratory work increased substantially during the pandemic and thus led to highly demanding working conditions with working shifts of more than eight hours working in PPE that stressed individual limits and also the ergonomic and safety limits of PPE. We provide detailed insights into the challenges of the stressful daily laboratory routine since the pandemic began, lessons learned, and suggest solutions for better safety based on a case study of a newly established HCBL designed for autopsies and research laboratory work. Reduced personal risk, increased resilience, and stress resistance can be achieved by improved PPE components, better training, redundant safety measures, inculcating a culture of safety, and excellent teamwork. (shrink)

Recent developments in Continental philosophy have included the emergence of a school of “speculative realism,” which rejects the human-centered orientation that has long dominated Continental thought. Proponents of speculative realism differ on several issues, but many agree on the need for an object-oriented ontology. Some speculative realists identify realism with materialism, while others accord equal reality to objects that are non-material, even fictional. Several thinkers retain a focus on difference, a well-established theme in Continental thought. This paper looks at speculative (...) realism from the perspective of systems theory. Many of the tenets of speculative realism have long been features of systems metaphysics and are expressed clearly in a systems framework. However, some views of some speculative realists differ substantially from systems theoretic ideas. (shrink)

The phenomenon of altruism extends from the biological realm to the human sociocultural realm. This article sketches a coherent outline of multiple types of altruism of progressively increasing scope that span these two realms and are grounded in an ever-expanding sense of “self.” Discussion of this framework notes difficulties associated with altruism at different levels. It links scientific ideas about the evolution of cooperation and about hierarchical order to perennial philosophical and religious concerns. It offers a conceptual background for inquiry (...) into societal challenges that call for altruistic behavior, especially the challenge of environmental and social sustainability. (shrink)

Michel Foucault’s later concept of parrhesia presents a number of potential interpretive problems with respect to his work as a whole and his conception of truth. This article presents an alternative reading of parrhesia , which develops its concept through Foucault’s earlier pronouncements on truth and fiction. Seen this way, parrhesia becomes a means whereby one enacts useful fictions within the context of one’s life. As a practice, which demands self-mastery, orientation towards truth, and a command of one’s life, parrhesia (...) becomes crucial to an aesthetics of existence. (shrink)

Die Entwicklung des Schalenmodells, deren Skizzierung an dieser Stelle abgebrochen wird, unterteilt sich deutlich in mehrere zeitlich voneinander getrennte Phasen. Ausgangspunkt der Entstehung des Schalenmodells ist die Betrachtung der bekannten Isotope, die erst mit der Entdeckung des Neutrons die schon vorhandene Idee des Kernschalenaufbaus quantitativ erfaßbar macht, und zwar durch noch ungenau bekannte ausgezeichnete Zahlen . Wie oft in der Geschichte der Naturwissenschaften wird eine solche erste Phase durch verschiedene spekulative Annahmen begleitet, die sich auf wenige Anhaltspunkte stützen müssen. Bereits (...) 1933 setzt eine andere Entwicklung ein, die neben der Darstellung empirischer Ergebnisse durch den Versuch gekennzeichnet ist, eine theoretische Begründung des Schalenmodells mit verschiedenen Kernpotentialen zu lieform. Es gelingt jedoch nicht, alle aufgetretenen Fragen befriedigend zu klären.Deutlich getrennt von der Entwicklung der ersten Jahre beginnt erst 1948 eine weitere Entstehungsphase des Schalenmodells. Im Unterschied zur den Jahren 1932–35 liegt 1948 eine Fülle empirischen Materials vor, dessen Erklärung erneut zur Betrachtung eines Schalenmodells anregt. Damit gelingt es, die meisten der offenen Fragen im wesentlichen mit Hilfe der Kernpotentiale und einer starken Spin-Bahn-Wechselwirkung zu beantworten. (shrink)

It is often claimed that the use of depth psychology in the interpretation of ancient texts is irrelevant and methodologically unsound. Several typical Jungian archetypes, such as the shadow, the primordial mother, and the hero, were identified, interpreted and commented on from a post-Jungian perspective. The apocryphal Book of Baruch has typically been studied as a prime example of penitential prayer in the late Second Temple Period. In this study, the book was approached from the perspective of post-Jungian literary criticism. (...) While Jungian literary criticism has become unfashionable as a result of Jung’s anti-feminist and anti-Semitic ideas, the usefulness of his theory to criticise itself was demonstrated. Although Jung’s work is haunted by racism, anti-feminism, and antisemitism, his work may still be useful for literary criticism from a psychological perspective.Contribution: The article demonstrated the value of the depth psychological approach to the interpretation of biblical material. (shrink)

In this lively collection ten philosophers tackle the notoriously elusive issues raised by religious discourse in a series of linked debates. The debates focus on reason and faith; the logic of mysticism; the meaning of the word 'God'; language, biblical interpretation and worship; and religion and ethics. Through contemporary philosophical analysis it is possible to shed new light on teh status and language of religion, and in many ways the contributors to Religion and Philosophy break new ground in this perennially (...) controversial field. The collection is addressed to philosophers, theologians and anyone with a general intellectual interest in religion. Certainly it will be a valuable addition to the reading list of all teachers or students of the philosophy of religion. (shrink)

Martin Wrights original ground-breaking and influential analysis of the defects of the adversarial system of justice, plus the arguments in favour of a more ...

Heidegger in America explores the surprising legacy of his life and thought in the United States of America. As a critic of modern life, Heidegger often lamented the growing global influence of all things American. However, it was precisely in America where his thought inspired the work of generations of thinkers – not only philosophers but also theologians, architects, novelists, and even pundits. As a result, the reception and dissemination of Heidegger's philosophical writings transformed the intellectual and cultural history of (...) the United States at a time when American influence was itself transforming the world. A case study in the complex and sometimes contradictory process of transnational exchange, Heidegger in America recasts the scope and methods of contemporary intellectual and cultural history in the age of globalization, challenging what we think we know about Heidegger and American ideas simultaneously. (shrink)

The seemingly innocuous description of Leah as having ‘soft’ eyes in Genesis 29:17 has captivated scholars and readers for centuries. This article advances an ironic interpretation, suggesting that Leah’s ‘soft’ eyes were not a sign of weakness but, rather, an indication of envy and malevolence, potentially contributing to fertility issues faced by her sister Rachel in terms of the ancient Near Eastern evil eye belief complex. In this context, the article delves into ancient belief systems that entwined beauty, fertility, and (...) the malevolent gaze.Contribution: Drawing from biblical texts, historical sources, and contemporary scholarship, this article reveals the intricate layers of meaning within this minor detail. (shrink)

In a project The Hastings Center is now running on the future of prenatal testing, we are encountering clear examples, both in established law and in the practices of individual providers, of failures to respect women's reproductive autonomy: when testing is not offered to certain demographics of women, for instance, or when the choices of women to terminate or continue pregnancies are prohibited or otherwise not supported. But this project also raises puzzles for reproductive autonomy. We have learned that some (...) clinicians and patients do not discuss the fact that prenatal testing can lead to a decision about whether to terminate a pregnancy—they just don't talk about it. And while the decision whether to agree to prenatal screening and diagnostic testing is to be made with women's free and informed consent, many screening tests have been routinized in such a way that some women do not even recall agreeing to testing, while others feel that agreeing to testing is what their clinicians expect of them or that the testing is necessary to protect themselves and their families from the significant financial hardship of raising a child with a disability. In the face of these pressures, can one really say that women are freely choosing to undergo testing or are freely choosing to continue or terminate a pregnancy following receipt of test results? The reality of these pressures is requiring us to consider expanding the scope of our investigation beyond the clinical encounter to the broader context—to think harder about what reproductive autonomy means and how best to enhance it. (shrink)

I draw lessons from experimental economics. I argue that the lack of mathematical formalism cannot be usefully thought as the cause of the underappreciation of contextual and generalizability considerations. Instead, this lack is problematic because it hinders a clear relationship between theory and quantitative predictions. I also advocate a pragmatic policy-focused approach as a partial remedy to the generalizability problem.

The discussion of collective agency involves the reduction problem of the concept of a collective. Individualism and Cartesian internalism have long restricted orthodox theories and made them face the tension between an irreducible concept of a collective and ontological reductionism. Heterodox theories as functionalism and interpretationism reinterpret the concept of agency and accept it as realized on the level of a collective. In order to adequately explain social phenomena that have relations as their essence, in this paper we propose a (...) relational, holistic account of collective agency and argue that functionalism and interpretationism can be integrated into such an account. (shrink)

It is often claimed that the use of depth psychology in the interpretation of ancient texts is irrelevant and methodologically unsound. Several typical Jungian archetypes, such as the shadow, the primordial mother, and the hero, were identified, interpreted and commented on from a post-Jungian perspective. The apocryphal Book of Baruch has typically been studied as a prime example of penitential prayer in the late Second Temple Period. In this study, the book was approached from the perspective of post-Jungian literary criticism. (...) While Jungian literary criticism has become unfashionable as a result of Jung’s anti-feminist and anti-Semitic ideas, the usefulness of his theory to criticise itself was demonstrated. Although Jung’s work is haunted by racism, anti-feminism, and antisemitism, his work may still be useful for literary criticism from a psychological perspective. Contribution: The article demonstrated the value of the depth psychological approach to the interpretation of biblical material. (shrink)

The possible integration of genomic sequencing (including whole‐genome and whole‐exome sequencing) into the three contexts addressed in this special report—state‐mandated screening programs, clinical care, and direct‐to‐consumer services—raises related but distinct legal issues. This essay will outline the legal issues surrounding the integration of genomic sequencing into state newborn screening programs, parental rights to refuse and access sequencing for their newborns in clinical and direct‐to‐consumer care, and privacy‐related legal issues attending the use of sequencing in newborns.

Moral luck is a puzzling aspect of our psychology: Why do we punish outcomes that were not intended (i.e. accidents)? Prevailing psychological accounts of moral luck characterize it as an accident or error, stemming either from a re‐evaluation of the agent's mental state or from negative affect aroused by the bad outcome itself. While these models have strong evidence in their favor, neither can account for the unique influence of accidental outcomes on punishment judgments, compared with other categories of moral (...) judgment. Why might punishment be particularly sensitive to moral luck? We suggest that such sensitivity is easily understood from the broader perspective of punishment's ultimate adaptive goal: Changing others’ behavior by exploiting their capacity to learn. This pedagogical perspective accounts for the exceptional influence of outcomes on punitive sentiments and makes predictions for additional moderators of punishment. We review evidence supporting the pedagogical hypothesis of punishment and discuss fruitful directions for future research. (shrink)

In most U.S. jurisdictions, clinicians providing informal “curbside” consults are protected from medical malpractice liability due to the absence of a doctor-patient relationship. A recent Minnesota Supreme Court case, Warren v. Dinter, offers the opportunity to reassess whether the majority rule is truly serving the best interests of patients.

This book review essay discusses Birth Rights and Wrongs: How Medicine and Technology Are Remaking Reproduction and the Law (2019), by Dov Fox.

I joined The Hastings Center this past summer, after graduating from Duke University, where I researched advancements in neuroscience and genomics and their import for law, ethics, and policy. This research required, to an extent, faith in the idea that researchers can identify pathways by which genes combine with epigenetic and environmental factors to affect neuronal activity and influence behaviors. Throughout my first months here, I have puzzled over broad critiques of “genomic hype” in recent literature, which clash with the (...) optimistic rhetoric found in the Human Genome Project and the Precision Medicine Initiative. (shrink)

This paper first offers a standard modal extension of dialetheic logics that respect the normal semantics for negation and conjunction, in an attempt to adequately model absolutism, the thesis that there are true contradictions at metaphysically possible worlds. It is shown, however, that the modal extension has unsavoury consequences for both absolutism and dialetheism. While the logic commits the absolutist to dialetheism, it commits the dialetheist to the impossibility of the actual world. A new modal logic AV is then proposed (...) which avoids these unsavoury consequences by invalidating the interdefinability rules for the modal operators with the use of two valuation relations. However, while using AV carries no significant cost for the absolutist, the same isn't true for the dialetheist. Although using AV allows her to avoid the consequence that the actual world is an impossible world, it does so only on the condition that the dialetheist admits that she cannot give a dialetheic solution to all self-refe.. (shrink)

In these essays, written between 1909 and 1954 and first published as a collection in 1957, the eminent philosopher relates the "I-Thou" dialogue to such varied fields as religion, social thought, philosophy, myth, drama, literature, and art. Buber thus responds to the crises and challenges of the 20th century and enables the reader to follow his lifelong struggles toward "authentic existence.".

How do people excluded from political life achieve political agency? Through a series of historical events that have been mostly overlooked by political theorists, Martin Breaugh identifies fleeting yet decisive instances of emancipation in which people took it upon themselves to become political subjects. Emerging during the Roman plebs's first secession in 494 BCE, the _plebeian experience_ consists of an underground or unexplored configuration of political strategies to obtain political freedom. The people reject domination through political praxis and concerted (...) action, therefore establishing an alternative form of power. Breaugh's study concludes in the nineteenth century and integrates ideas from sociology, philosophy, history, and political science. Organized around diverse case studies, his work undertakes exercises in political theory to show how concepts provide a different understanding of the meaning of historical events and our political present. _The Plebeian Experience_ describes a recurring phenomenon that clarifies struggles for emancipation throughout history, expanding research into the political agency of the many and shedding light on the richness of radical democratic struggles from ancient Rome to Occupy Wall Street and beyond. (shrink)

In recent years consciousness has become a significant area of study in the cognitive sciences. The Frontiers of Consciousness is a major interdisciplinary exploration of consciousness. The book stems from the Chichele lectures held at All Souls College in Oxford, and features contributions from a 'who's who' of authorities from both philosophy and psychology. The result is a truly interdisciplinary volume, which tackles some of the biggest and most impenetrable problems in consciousness. The book includes chapters considering the apparent explanatory (...) gap between science and consciousness, our conscious experience of emotions such as fear, and of willed actions by ourselves and others. It looks at subjective differences between two ways in which visual information guides behaviour, and scientific investigation of consciousness in non-human animals. It looks at the challenges that the mind-brain relation presents for clinical practice as well as for theories of consciousness. The book draws on leading research from philosophy, experimental psychology, functional imaging of the brain, neuropsychology, neuroscience, and clinical neurology. Distinctive in its accessibility, authority, and its depth of coverage, Frontiers of Consciousness will be a groundbreaking and influential addition to the consciousness literature. (shrink)

The philosophical papers comprising this volume range from process metaphysics and theology, through the phenomenological study of intentionality, to the foundations of geometry and of the system of real numbers. New light, it is thought, is shed on all these topics, some of them being of the highest interest and under intensive investigation in contemporary philosophical discussion. Metaphysi cians, process theologians, semanticists, theorists of knowledge, phenomenologists, and philosophers of mathematics will thus find in this book, it is hoped, helpful materials (...) and methods. The categoreal scheme of Whitehead's Process and Reality is discussed rather fully from a logical point of view in the first paper [I] in the light of the author's previous work on the logico-metaphysical theory of events. The clarification that results is thought to provide a new depth and precision to the problem of interpreting one of the most difficult books in the recent history of metaphysics and cosmol ogy. A detailed examination of some aspects of Hartshorne's recent Creative Synthesis and Philosophic Method is given in II. This book is perhaps the most significant work on process philosophy since Process and Reality itself, and its logical underpinnings thus merit a full critical discussion. (shrink)

As founder of modern political economics and prominent theorist of the commercial society, Adam Smith’s importance is universally recognized. Little, however, has been done so far to develop Adam Smith’s virtue ethics in the context of modern business, characterized by digitalization. This article aims to rediscover Adam Smith’s virtue of prudence and its relevance for the “e-commercial society”: It presents a framework that considers the central place of prudence in the relationship between a prosperous e-commercial system and societal flourishing. In (...) Smith’s view of the commercial society, prudence enables people to develop habits of character related to industriousness, genuineness, spirit of sacrifice, and self-command, which help in the conduct of a prosperous business activity. This article translates Smith’s virtue of prudence into a language typical of consumers in the current e-commerce scenario, considering their development as persons and the contribution of their activities to the good of society. (shrink)