BackgroundThe emergence of artificial intelligence (AI) in medicine has prompted the development of numerous ethical guidelines, while the involvement of patients in the creation of these documents lags behind. As part of the European PROFID project we explore patient perspectives on the ethical implications of AI in care for patients at increased risk of sudden cardiac death (SCD).AimExplore perspectives of patients on the ethical use of AI, particularly in clinical decision-making regarding the implantation of an implantable cardioverter-defibrillator (ICD).MethodsSemi-structured, future scenario-based (...) interviews were conducted among patients who had either an ICD and/or a heart condition with increased risk of SCD in Germany (n = 9) and the Netherlands (n = 15). We used the principles of the European Commission’s Ethics Guidelines for Trustworthy AI to structure the interviews.ResultsSix themes arose from the interviews: the ability of AI to rectify human doctors’ limitations; the objectivity of data; whether AI can serve as second opinion; AI explainability and patient trust; the importance of the ‘human touch’; and the personalization of care. Overall, our results reveal a strong desire among patients for more personalized and patient-centered care in the context of ICD implantation. Participants in our study express significant concerns about the further loss of the ‘human touch’ in healthcare when AI is introduced in clinical settings. They believe that this aspect of care is currently inadequately recognized in clinical practice. Participants attribute to doctors the responsibility of evaluating AI recommendations for clinical relevance and aligning them with patients’ individual contexts and values, in consultation with the patient.ConclusionThe ‘human touch’ patients exclusively ascribe to human medical practitioners extends beyond sympathy and kindness, and has clinical relevance in medical decision-making. Because this cannot be replaced by AI, we suggest that normative research into the ‘right to a human doctor’ is needed. Furthermore, policies on patient-centered AI integration in clinical practice should encompass the ethics of everyday practice rather than only principle-based ethics. We suggest that an empirical ethics approach grounded in ethnographic research is exceptionally well-suited to pave the way forward. (shrink)

Avant de s'emparer de ce qu'elle sait, ou croit savoir, pour élaborer des théories, l'intelligence, lorsqu'elle s'éveille, est d'abord frappée par des évidences qui s'imposent à elle. A ce moment-là, l'intelligence est saisie, donc elle sort d'elle-même en s'ouvrant à la réalité, et elle en est consciente. Bref, elle tient une vérité. En même temps, ces lumières n'expliquent pas tout ;par conséquent, elles suscitent, tout naturellement, des questions. De là va naître ce que, à la suite de saint Thomas d'Aquin, (...) on a appelé :" la philosophie naturelle de l'esprit humain " qui, seule, peut nous délivrer, définitivement et objectivement, du relativisme et du vide, donc du désespoir. Point de départ de ces réflexions, la découverte de l'être et de sa nécessité dans l'évidence, intellectuelle qu'il y a quelque chose de bon et de beau en face de moi. A partir de là on discerne, certes, l'Erre perfection pure, mais surtout l'immatérialité de la connaissance, sans laquelle l'amour perd toute sa profondeur, et qui est le fondement de notre ressemblance à Dieu. C'est dire assez à quel point la foi suppose cette philosophie. Ces pages veulent s'adresser aux non-spécialistes, tout en essayant de répondre aux exigences de rigueur d'un esprit critique. Exercice difficile, mais à la hauteur de l'enjeu, exprimé de façon saisissante par Dimitri Karamazov :"Je suis fort peu instruit, frère, mais j'ai beaucoup songé à ces choses. Que de mystères accablent l'homme! Pénètre-les et reviens intact. ". (shrink)

Several studies have focused on the effects of corporate social responsibility fit on external stakeholders’ evaluations of CSR activities, attitudes towards companies or brands, and behaviors. The results so far have been contradictory. A possible reason may be that the concept of CSR fit is more complicated than previously assumed. Researchers suggest that there may be different types of CSR fit, but so far no empirical research has focused on a typology of CSR fit. This study fills this gap, describing (...) a qualitative content analysis of the congruence between six organizations and their various CSR activities. Ten annual reports and CSR reports were analyzed, and 102 specific CSR activities were identified. The results show that two levels of fit must be distinguished: based on the means for and the intended ends of the CSR activity. Furthermore, six different types of fit were found, focusing on products and services, production processes, environmental impact, employees, suppliers, and geographical location. Considering the above variety of fit possibilities, the findings emphasize the role of CSR communication as a means of creating fit perceptions. (shrink)

Desire After Affect offers a detailed analysis of the affective turn and its consequences for the humanities.

St. Augustine of Hippo wrote the ’De Trinitate’ to explain to critics of the Nicene Creed how the Christian doctrine of the divinity and coequality of Father, Son, and Holy Spirit is present in Scripture. He also wanted to convince philosophers that Christ is the Wisdom they sought. Augustine’s third purpose was to correlate the biblical truth that all human persons are created to image God, a Trinity, a communion of love, with the first two Commandments of the Old and (...) New Testaments. Augustine succeeded in showing the need for combining faith and reason for a greater understanding of Scripture as well as for a greater understanding of the true nature and destiny of human persons. Augustine emphasized the scriptural revelation of God as Father, Son, and Holy Spirit, and used reason to convince philosophers that the one and three-Personed God is philosophically and logically defensible. He concluded that the likeness of human persons to Christ and to the Trinity is accomplished not onl. (shrink)

The Hebrew Scriptures reveal that for the Hebrews the physical body was fundamental. In thinking of human existence they did not isolate mental processes from sense reactions and bodily feelings. The word "heart" was often used instead of a personal pronoun. In Judges 19, "Comfort thy heart with a morsel of bread" means "Give yourself comfort." In Exodus 33:14, "My face will go with thee," means "I will go with thee." The word ruah, or spirit, denoting breath or wind, referred (...) to anyone who by physical energy and mental alertness was full of life. In many cases the word "heart" was used to bring together the feelings, motives, intentions, and other aspects of an individual as a whole. The word "heart" referred to psychic activity, not merely to a physical organ. (shrink)

Canadian and American population-based research concerning sexual and/or gender minority populations provides evidence of persistent breast and gynecologic cancer-related health disparities and knowledge divides. The Cancer's Margins research investigates the complex intersections of sexual and/or gender marginality and incommensurabilities and improvisation in engagements with biographical and biomedical cancer knowledge. The study examines how sexuality and gender are intersectionally constitutive of complex biopolitical mappings of cancer health knowledge that shape knowledge access and its mobilization in health and treatment decision-making. Interviews were (...) conducted with a diverse group of sexual and/or gender minority breast or gynecologic cancer patients. The LGBQ//T2 cancer patient narratives we have analyzed document in fine grain detail how it is that sexual and/or gender minority cancer patients punctuate the otherwise lockstep assemblage of their cancer treatment decision-making with a persistent engagement in creative attempts to resist, thwart and otherwise manage the possibility of discrimination and likewise, the probability of institutional erasure in care settings. Our findings illustrate the demands that cancer places on LGBQ//T2 patients to choreograph access to, and mobilization of knowledge and care, across significantly distinct and sometimes incommensurable systems of knowledge. (shrink)

Background:Clinical investigation is a growing field employing increasing numbers of nurses. This has created a new specialty practice defined by aspects unique to nursing in a clinical research context: the objectives, setting, and nature of the nurse–participant relationship. The clinical research nurse role may give rise to feelings of ethical conflict between aspects of protocol implementation and the duty of patient advocacy, a primary nursing responsibility. Little is known about whether research nurses experience unique ethical challenges distinct from those experienced (...) by nurses in traditional patient-care settings.Research objectives:The purpose of the study was to describe the nature of ethical challenges experienced by clinical research nurses within the context of their practice.Research design:The study utilized a qualitative descriptive design with individual interviews.Participants and research context:Participating nurses self-identified as having experienced ethical challenges during screening. The majority were Caucasian, female, and worked in outpatient settings. Approximately 50% had > 10 years of research experience.Ethical considerations:The human subjects review board approved the study. Written informed consent was obtained.Findings:Predominant themes were revealed: the inability to provide a probable good, or/do no harm, and dual obligations. The following patterns and subthemes emerged: conflicted allegiances between protocol implementation, needs of the participant, desire to advance science, and tension between the nurse–patient therapeutic relationship versus the research relationship.Discussion:Participants described ethical challenges specific to the research role. The issues are central to the nurse–participant relationship, patient advocacy, the nurse’s role in implementing protocols, and/or advancing science.Conclusion:Ethical challenges related to the specialized role of clinical research nurses were identified. More research is warranted to fully understand their nature and frequency and to identify support systems for resolution. (shrink)

Historically, treatment for pain relief has varied according to the social status of the sufferer. A similar tendency to make arbitrary distinctions affecting pain relief was found in an ethnographic study of animal research laboratories. The administration of pain-relieving drugs for animals in laboratories differed from standard practice for humans and, perhaps, for companion animals. Although anesthesia was used routinely for surgical procedures, its administration was sometimes haphazard. Analgesics, however, were rarely used. Most researchers had never thought about using analgesics (...) and did not consider the subject worthy of serious attention. Scientists interviewed for this study agreed readily that animals are capable offeeling pain, but such assertions were muted by an overriding view of lab animals as creatures existing solely for the purposes of research. As a result, it was the exceptional scientist who was able to focus on anything about the animal's subjective experience that might lie outside the boundaries of the research protocol. (shrink)

This volume examines some of the most contentious social justice issues present in the corpus of Augustine's writings. Whether one is concerned with human trafficking and the contemporary slave trade, the global economy, or endless wars, these essays further the conversation on social justice as informed by the writings of Augustine of Hippo.

Eddington, A. The decline of determinism.--Heisenberg, W. and others. Dialogue concerning science and philosophical positions.--Sinnott, E. Biology and freedom.--Nuttin, J. The unconscious and freedom.--Nagel, E. Determinism in history.--Ayer, A. J. Freedom and necessity.--Campbell, C. A. Philosophical defence of freedom.--Hare, R. M. Freedom and reason.--Dewey, J. Freedom as a problem.--Sartre, J.-P. Freedom and total responsibility.--Camus, A. Freedom and rebellion.--Rand, A. Freedom and individualism.--Thévenaz, P. Freedom and action.--Luijpen, W. A. Phenomenology of freedom.--Teilhard de Chardin, P. Cosmic freedom.--Jaspers, K. Freedom and society.--Macmurray, J. (...) Freedom in the personal nexus.--Brunner, A. Incarnation of freedom.--Ricoeur, P. Freedom as human creativity.--Finance, J. de. Freedom and existence.--Bibliography (p. 243-251). (shrink)