Prehospital ambulance based research has unique ethical considerations due to urgency, time limitations and the locations involved. We sought to explore these issues through interviews with experts in this research field. We undertook semi-structured interviews with expert informants, primarily based in the UK, seeking their views and experiences of ethics in ambulance based clinical research. Participants were questioned regarding their experiences of ambulance based research, their opinions on current regulations and guidelines, and views about their general ethical considerations. Participants were (...) chosen because they were actively involved in, or in their expert capacity expressed an interest in, ambulance based research. Fourteen participants were interviewed including principal investigators, researchers, ethicists and medical lawyers. Five major themes were identified: Capacity, Consent, Clinical Considerations, Consultation and Regulation. Questions regarding consent and capacity were foremost in the discussions as all participants highlighted these as areas for concern. The challenges and use of multiple consent models reflected the complexity of research in this environment. The clinical theme referred to the role of paramedics in research and how research involving ambulance services is increasingly informing improvements to patient care and outcomes and reducing the burden on hospital services. Most felt that, although current regulations were fit for purpose, more specific guidance on implementing these in the ambulance setting would be beneficial. This related closely to the theme of consultation, which examined the key role of ethics committees and other regulatory bodies, as well as public engagement. By interviewing experts in research or ethics in this setting we were able to identify key concerns and highlight areas for future development such as improved guidance. (shrink)

ADVANGEBOOKS - UNDERSTANDING ARGUMENTS: AN INTRODUCTION TO INFORMAL LOGIC, 9E shows readers how to construct arguments in everyday life, using everyday language. In addition, this easy-to-read textbook also devotes three chapters to the formal aspects of logic including forms of argument, as well as propositional, categorical, and quantificational logic. Plus, this edition helps readers apply informal logic to legal, moral, scientific, religious, and philosophical scenarios, too. Important Notice: Media content referenced within the product description or the product text may not (...) be available in the ebook version. (shrink)

Whenever psychologists, neuroscientists, or philosophers draw conclusions about moral judgments in general from a small selected sample, they assume that moral judgments are unified by some common and peculiar feature that enables generalizations and makes morality worthy of study as a unified field. We assess this assumption by considering the six main candidates for a unifying feature: content, phenomenology, force, form, function, and brain mechanisms. We conclude that moral judgment is not unified on any of these levels and that moral (...) science should adopt a more fine-grained taxonomic approach that studies carefully defined groups of moral judgments. (shrink)

This book should fit well with the debates raging over issues like evolution and intelligent design, atheism, and religion and public life as an example of a ...

De Marco et al 1 argue that the standard account of medical ‘invasiveness’ (as ‘incision’ or ‘insertion’) fails to capture three aspects of its existing use, namely that invasiveness can come in degrees, often depends on features of alternative medical interventions and can be non-physical. They propose a new schematic account that suggests that medical interventions can possess ‘basic invasiveness’ (which can come in degrees and of which they suggest at least two types: physical and mental), and ‘threshold invasiveness’ which (...) can depend on the alternatives a specific intervention is being compared with. While we agree that the standard account of invasiveness fails to capture existing use and are supportive of their aim, here we express scepticism about the practical utility of De Marco et al ’s revised account. Our scepticism concerns the application of De Marco et al’s revised account in the narrow context of clinician–patient communication and deliberation about medical interventions within clinical practice, which we see as a crucial context for its use. While De Marco et al do not specify the contexts in which their revised account could be used, we assume from their discussion of treatment interventions (e.g. non-invasive prenatal testing, ventilation) and their comparison to ‘more or less invasive’ options, that at least one of the purposes in mind for …. (shrink)

In Moral Knowledge? New Readings in Moral Epistemology, editors Walter Sinnott-Armstrong and Mark Timmons bring together eleven specially commissioned essays by distinguished moral philosophers exploring the nature and possibility of moral knowledge. Each essay represents a major position within the exciting field of moral epistemology in which a proponent of the position presents and defends his or her view and locates it vis-a-vis competing views. The authors include established philosophers such as Peter Railton, Robert Audi, Richard Brandt, and Simon (...) Blackburn, as well as newer voices in the field. Topics covered include moral skepticism, moral truth, projectivism, contractarianism, coherentism, feminist views, quasi-realism, and pragmatism. The lively and clear selections do not presuppose specialized knowledge of philosophy, and the philosophical vocabulary used throughout the anthology is uniform, in order to facilitate understanding by those not familiar with the field. The first chapter includes a sustained critical discussion of the major views represented in the following chapters, thereby furnishing beginning students with appropriate background to understand the selections. The volume is further enhanced by an index and an extensive bibliography. An excellent text for undergraduate and graduate courses, Moral Knowledge provides the most up-to-date work on moral knowledge and justification. (shrink)

Much has been written about the need for trustworthy artificial intelligence (AI), but the underlying meaning of trust and trustworthiness can vary or be used in confusing ways. It is not always clear whether individuals are speaking of a technology’s trustworthiness, a developer’s trustworthiness, or simply of gaining the trust of users by any means. In sociotechnical circles, trustworthiness is often used as a proxy for ‘the good’, illustrating the moral heights to which technologies and developers ought to aspire, at (...) times with a multitude of diverse requirements; or at other times, no specification at all. In philosophical circles, there is doubt that the concept of trust should be applied at all to technologies rather than their human creators. Nevertheless, people continue to intuitively reason about trust in technologies in their everyday language. This qualitative study employed an empirical ethics methodology to address how developers and users define and construct requirements for trust throughout development and use, through a series of interviews. We found that different accounts of trust (rational, affective, credentialist, norms based, relational) served as the basis for individual granting of trust in technologies and operators. Ultimately, the most significant requirement for user trust and assessment of trustworthiness was the accountability of AI developers for the outputs of AI systems, hinging on the identification of accountable moral agents and perceived value alignment between the user and developer’s interests. (shrink)

This paper explores some ways in which artificial intelligence (AI) could be used to improve human moral judgments in bioethics by avoiding some of the most common sources of error in moral judgment, including ignorance, confusion, and bias. It surveys three existing proposals for building human morality into AI: Top-down, bottom-up, and hybrid approaches. Then it proposes a multi-step, hybrid method, using the example of kidney allocations for transplants as a test case. The paper concludes with brief remarks about how (...) to handle several complications, respond to some objections, and extend this novel method to other important moral issues in bioethics and beyond. (shrink)

There is disagreement in the literature about the exact nature of the phenomenon of empathy. There are emotional, cognitive, and conditioning views, applying in varying degrees across species. An adequate description of the ultimate and proximate mechanism can integrate these views. Proximately, the perception of an object's state activates the subject's corresponding representations, which in turn activate somatic and autonomic responses. This mechanism supports basic behaviors that are crucial for the reproductive success of animals living in groups. The Perception-Action Model, (...) together with an understanding of how representations change with experience, can explain the major empirical effects in the literature. It can also predict a variety of empathy disorders. The interaction between the PAM and prefrontal functioning can also explain different levels of empathy across species and age groups. This view can advance our evolutionary understanding of empathy beyond inclusive fitness and reciprocal altruism and can explain different levels of empathy across individuals, species, stages of development, and situations. Key Words: altruism; cognitive empathy ; comparative; emotion; emotional contagion; empathy ; evolution; human; perception-action; perspective taking. (shrink)

Illness creates a range of negative emotions in patients including anxiety, fear, powerlessness, and vulnerability. There is much debate on the ‘therapeutic’ or ‘helping’ nurse–patient relationship. However, despite the current agenda regarding patient-centred care, the literature concerning the development of good interpersonal responses and the view that a satisfactory nursing ethics should focus on persons and character traits rather than actions, nursing ethics is dominated by the traditional obligation, act-centred theories such as consequentialism and deontology. I critically examine these theories (...) and the role of duty-based notions in both general ethics and nursing practice. Because of well-established flaws, I conclude that obligation-based moral theories are incomplete and inadequate for nursing practice. I examine the work of Hursthouse on virtue ethics’ action guidance and the v-rules. I argue that the moral virtues and a strong (action-guiding) version of virtue ethics provide a plausible and viable alternative for nursing practice. I develop an account of a virtue-based helping relationship and a virtue-based approach to nursing. The latter is characterized by three features: (1) exercising the moral virtues such as compassion; (2) using judgement; and (3) using moral wisdom, understood to include at least moral perception, moral sensitivity, and moral imagination. Merits and problems of the virtue-based approach are examined. I relate the work of MacIntyre to nursing and I conceive nursing as a practice: nurses who exercise the virtues and seek the internal goods help to sustain the practice of nursing and thus prevent the marginalization of the virtues. The strong practice-based version of virtue ethics proposed is context-dependent, particularist, and relational. Several areas for future philosophical inquiry and empirical nursing research are suggested to develop this account yet further. (shrink)

In his last book, David Armstrong sets out his metaphysical system in a set of concise and lively chapters each dealing with one aspect of the world. He begins with the assumption that all that exists is the physical world of space-time. On this foundation he constructs a coherent metaphysical scheme that gives plausible answers to many of the great problems of metaphysics. He gives accounts of properties, relations, and particulars; laws of nature; modality; abstract objects such as numbers; (...) and time and mind. (shrink)

Many meta-ethicists are alethists: they claim that practical considerations can constitute normative reasons for action, but not for belief. But the alethist owes us an account of the relevant difference between action and belief, which thereby explains this normative difference. Here, I argue that two salient strategies for discharging this burden fail. According to the first strategy, the relevant difference between action and belief is that truth is the constitutive standard of correctness for belief, but not for action, while according (...) to the second strategy, it is that practical considerations can constitute motivating reasons for action, but not for belief. But the former claim only shifts the alethist's explanatory burden, and the latter claim is wrong—we can believe for practical reasons. Until the alethist can offer a better account, then, I argue that we should accept that there are practical reasons for belief. (shrink)

A surfeit of research confirms that people activate personal, affective, and conceptual representations when perceiving the states of others. However, researchers continue to debate the role of self–other overlap in empathy due to a failure to dissociate neural overlap, subjective resonance, and personal distress. A perception–action view posits that neural-level overlap is necessary during early processing for all social understanding, but need not be conscious or aversive. This neural overlap can subsequently produce a variety of states depending on the context (...) and degree of common experience and emotionality. We outline a framework for understanding the interrelationship between neural and subjective overlap, and among empathic states, through a dynamic-systems view of how information is processed in the brain and body. (shrink)

With the growth of precision medicine research on health data and biospecimens, research institutions will need to build and maintain long-term, trusting relationships with patient-participants. While trust is important for all research relationships, the longitudinal nature of precision medicine research raises particular challenges for facilitating trust when the specifics of future studies are unknown. Based on focus groups with racially and ethnically diverse patients, we describe several factors that influence patient trust and potential institutional approaches to building trustworthiness. Drawing on (...) these findings, we suggest several considerations for research institutions seeking to cultivate long-term, trusting relationships with patients: Address the role of history and experience on trust, engage concerns about potential group harm, address cultural values and communication barriers, and integrate patient values and expectations into oversight and governance structures. (shrink)

Analytic particularism claims that judgments of moral wrongness are about particular acts rather than general principles. Metaphysical particularism claims that what makes true moral judgments true is not general principles but nonmoral properties of particular acts. Epistemological particularism claims that studying particular acts apart from general principles can justify beliefs in moral judgments. Methodological particularism claims that we will do better morally in everyday life if we look carefully at each particular decision as it arises and give up the search (...) for a complete moral theory. This paper raises problems for each of these versions of particularism. (shrink)

This chapter argues that the best way for a non-naturalist to explain why the normative supervenes on the natural is to claim that, while there are some sui generis normative properties whose essences cannot be fully specified in non-normative terms and do not specify any non-normative sufficient conditions for their instantiation, there are certain hybrid normative properties whose essences specify both naturalistic sufficient conditions for their own instantiation and sufficient conditions for the instantiation of certain sui generis normative properties. This (...) is the only metaphysical explanation for supervenience on offer, the chapter argues, that can both clearly maintain the pre-theoretical commitments of non-naturalism, and provide a metaphysical explanation not just for supervenience, but for all metaphysical necessities involving natural and normative properties. (shrink)

Business and Society Review, Volume 127, Issue S1, Page 283-298, Spring 2022.

Digital phenotyping will potentially enable earlier detection and prediction of mental illness by monitoring human interaction with and through digital devices. Notwithstanding its promises, it is certain that a person’s digital phenotype will at times be at odds with their first-person testimony of their psychological states. In this paper, we argue that there are features of digital phenotyping in the context of psychiatry which have the potential to exacerbate the tendency to dismiss patients’ testimony and treatment preferences, which can be (...) instances of epistemic injustice. We first explain what epistemic injustice is, and why it is argued to be an extensive problem in health and disability settings. We then explain why epistemic injustice is more likely to apply with even greater force in psychiatric contexts, and especially where digital phenotyping may be involved. Finally, we offer some tentative suggestions of how epistemic injustice can be minimised in digital psychiatry. (shrink)

Climate change is more than a discrete issue demanding political attention and response. A changing climate permeates political life as material processes of planetary change reverberate in our bodies, affecting subterranean processes of attention and evoking bodily responses at and below the threshold of awareness. By way of example, I explore the register of bodily feeling to raise the possibility that proliferating anomalies in atmospheric, oceanic, and seismic activities are entering into subliminal experiences of time and confounding embodied expectations of (...) how the future is likely to flow from the past. The essay concludes with a preliminary discussion of how micropolitical strategies to amplify visceral experiences of climatic changes might valuably contribute to larger programs for climate action. (shrink)

Unconsented pelvic exams under anesthesia are assaults cloaked in defense of healthcare education. Preemptive linguistic qualifiers “presumed” or “implied” attempt to justify such violations with flippancy toward their oxymoronic implications: to suggest a priori that consent can be assumed undermines its otherwise standalone social, ethical, and medico-legal reverence. In this paper I conceptualize “medical sexual assault” and argue that presumed consent for intimate exams exemplifies its definition. By bluntly describing pelvic exams as “penetration,” this work aims to reify the intimate (...) reality of the clinical label “pelvic exam” and to call attention to cisheteronormative and androcentric assumptions involved in its practice. Additionally, this scholarship seeks to create a foundation toward broader work in conceptualizing clinical rape culture. Given recent national survey data indicating a surprising frequency of unconsented intimate exams, detailed language as to their problematics is necessary for ongoing legal and ethical efforts. Explicit consent for intimate exams must be the standard of care for conscious and unconscious patients. (shrink)

Growing interest in embedded research approaches—where research is incorporated into clinical care—has spurred numerous studies to generate knowledge relevant to the real-world needs of patients and other stakeholders. However, it also has presented ethical challenges. An emerging challenge is how to understand the nature and extent of investigators’ obligations to patient-subjects. Prior scholarship on investigator duties has generally been grounded upon the premise that research and clinical care are distinct activities, bearing distinct duties. Yet this premise—and its corresponding implications—are challenged (...) when research and clinical care are deliberately integrated. After presenting three case studies from recent pragmatic clinical trials, we identify six differences between explanatory trials and embedded research that limit the application of existing scholarship for ascertaining investigator duties. We suggest that these limitations indicate a need to account for the implications of usual care and to move beyond a narrow focus on the investigator-subject dyad, one that better reflects the team- and institution-based nature of contemporary health systems. (shrink)

Moral duties are regularly attributed to groups. Does this make conceptual sense or is this merely political rhetoric? And what are the implications for these individuals within groups? Collins outlines a Tripartite Model of group duties that can target political demands at the right entities, in the right way and for the right reasons.

Classic statements of research ethics advise against permitting physician-investigators to obtain consent for research participation from patients with whom they have preexisting treatment relationships. Reluctance about “dual-role” consent reflects the view that distinct normative commitments govern physician–patient and investigator–participant relationships, and that blurring the research–care boundary could lead to ethical transgressions. However, several features of contemporary research demand reconsideration of the ethics of dual-role consent. Here, we examine three arguments advanced against dual-role consent: that it creates role conflict for the (...) physician-investigator; that it can compromise the voluntariness of the patient-participant’s consent; and that it promotes therapeutic misconceptions. Although these concerns have merit in some circumstances, they are not dispositive in all cases. Rather, their force—and the ethical acceptability of dual-role consent—varies with features of the particular study. As research participation more closely approximates usual care, it becomes increasingly acceptable, or even preferable, for physicians to seek consent for research from their own patients. It is time for a more nuanced approach to dual-role consent. (shrink)

Throughout the Covid-19 pandemic, people have been eager to learn what factors, and especially what public health policies, cause infection rates to wax and wane. But figuring out conclusively what causes what is difficult in complex systems with nonlinear dynamics, such as pandemics. We review some of the challenges that scientists have faced in answering quantitative causal questions during the Covid-19 pandemic, and suggest that these challenges are a reason to augment the moral dimension of conversations about causal inference. We (...) take a lesson from Martha Nussbaum—who cautions us not to think we have just one question on our hands when we have at least two—and apply it to modeling for causal inference in the context of cost-benefit analysis. (shrink)

The pragmatism—anti-pragmatism debate concerns whether practical considerations can constitute genuinely normative wrong-kind reasons (WKRs) for and against doxastic attitudes, whereas the encroachment—anti-encroachment debate concerns whether practical considerations can affect what right-kind reasons (RKRs) one has or needs to have in order to enjoy some epistemic status. While these are two separate issues, my main aim is to show that pragmatists have a plausible debunking explanation to offer of encroachment cases: that the practical considerations in these cases only generate WKRs against (...) belief, rather than affect the RKRs one has or needs to have, so that the agents in these cases ought to withhold belief, but only in a practical or all-things-considered sense. Moreover, I argue that the pragmatist debunker's explanation of what's going on in encroachment cases is more plausible than the encroacher's because they're structurally identical to cases involving WKRs against other attitudes like admiration and fear. These analogous WKR-cases not only support the surprising conclusion that pragmatists should be anti-encroachers, but they also challenge the encroacher's view independently of whether pragmatism is true. (shrink)

In the third Critique Kant details an aesthetic operation of judgment that is surprising considering how judgment functioned in the first Critique. In this book, I defend an understanding of Kant’s theory of Geschmacksurteil as detailing an operation of the faculties that does not violate the cognitive structure laid out in the first Critique. My orientation is primarily epistemological, elaborating the determinations that govern the activity of pure aesthetic judging that specify it as a "bestimmte" type of judgment without transforming (...) it into "ein bestimmendes Urteil". I focus on identifying how the logical functions from the table of judgments operate in the pure aesthetic judgment of taste to reveal "the moments to which this power of judgment attends in its reflection". In the course of doing so, a picture emerges of how the world is not just cognizable in a Kantian framework but also charged with human feeling, acquiring the inexhaustible, inchoate meaningfulness that incites "much thinking". The universal communicability of aesthetic pleasure serves as the foundation that grounds robust intersubjective relations, enabling genuine connection to others through a shared a priori feeling. (shrink)

It is well established that beliefs provide powerful cues that influence reasoning. Over the last decade research has revealed that judgments based upon logical structure may also pre-empt deliberative reasoning. Evidence for ‘intuitive logic’ has been claimed using a range of measures (i.e. confidence ratings or latency of response on conflict problems). However, it is unclear how well such measures genuinely reflect logical intuition. In this paper we introduce a new method designed to test for evidence of intuitive logic. In (...) two experiments participants were asked to make random judgments about the logical validity of a series of simple and complex syllogistic arguments. For simple arguments there was an effect of logical validity on random responding, which was absent for complex arguments. These findings provide a novel demonstration that people are intuitively sensitive to logical structure. (shrink)

David Lewis famously argued that the time traveller ‘can’ murder her grandfather, even though she never will: it is compossible with a particular set of facts including her motive, opportunity and skill . I argue that while ordinary agents ‘can’ under Lewis’s conception, philosophers cannot – the latter will not only fail to fulfill their homicidal intentions but also fail to form them in the first place.

In a recent and provocative essay, Christopher Bartel attempts to resolve the gamer’s dilemma. The dilemma, formulated by Morgan Luck, goes as follows: there is no principled distinction between virtual murder and virtual pedophilia. So, we’ll have to give up either our intuition that virtual murder is morally permissible—seemingly leaving us over-moralizing our gameplay—or our intuition that acts of virtual pedophilia are morally troubling—seemingly leaving us under-moralizing our game play. Bartel’s attempted resolution relies on establishing the following three theses: (1) (...) virtual pedophilia is child pornography, (2) the consumption of child pornography is morally wrong, and (3) virtual murder is not murder. Relying on Michael Rea’s definition of pornography, I argue that we should reject thesis one, but since Bartel’s moral argument in thesis two does not actually rely thesis one that his resolution is not thereby undermined. Still, even if we grant that there are adequate resources internal to Bartel’s account to technically resolve the gamer’s dilemma his reasoning is still unsatisfying. This is so because Bartel follows Neil Levy in arguing that virtual pedophilia is wrong because it harms women. While I grant Levy’s account, I argue that this is the wrong kind of reason to resolve the gamer’s dilemma because it is indirect. What we want is to know what is wrong with virtual child pornography itself. Finally, I suggest alternate moral resources for resolving the gamer’s dilemma that are direct in a way that Bartel’s resources are not. (shrink)

Metaethicists often specify non-naturalism in different ways: some take it to be about identity, while others take it to be about grounding. But few directly address the taxonomical question of what the best way to understand non-naturalism is. That’s the task of this paper. This isn’t a merely terminological question about how to use the term “non-naturalism”, but a substantive philosophical one about what metaphysical ideology we need to capture the pre-theoretical concerns of non-naturalists. I argue that, contrary to popular (...) opinion, non-naturalism is best characterized not in terms of identity or grounding, but in terms of essence. First, I lay out some desiderata for a good characterization of non-naturalism: it should (i) speak to and elucidate the non-naturalist’s core pre-theoretical commitments, (ii) render non-naturalism a substantive, local claim about normativity, and (iii) provide the most general characterization of the view possible (iv) in a way that best fits the spirit of paradigm non-naturalist views. I then argue that identity characterizations fail to satisfy the former two desiderata, while grounding characterizations at best don’t satisfy the latter two. So, I propose a new essence characterization of non-naturalism and argue that it does a better job of satisfying all four desiderata. Moreover, I argue that this essence characterization has important implications for both metaethical and metaphysical theorizing. (shrink)

Scientific modelling is a value-laden process: the decisions involved can seldom be made using ‘scientific’ criteria alone, but rather draw on social and ethical values. In this paper, we draw on a body of philosophical literature to analyze a COVID-19 vaccination model, presenting a case study of social and ethical value judgments in health-oriented modelling. This case study urges us to make value judgments in health-oriented models explicit and interpretable by non-experts and to invite public involvement in making them.

It is well established that beliefs provide powerful cues that influence reasoning. Over the last decade research has revealed that judgments based upon logical structure may also pre-empt deliberative reasoning. Evidence for ‘intuitive logic’ has been claimed using a range of measures (i.e. confidence ratings or latency of response on conflict problems). However, it is unclear how well such measures genuinely reflect logical intuition. In this paper we introduce a new method designed to test for evidence of intuitive logic. In (...) two experiments participants were asked to make random judgments about the logical validity of a series of simple and complex syllogistic arguments. For simple arguments there was an effect of logical validity on random responding, which was absent for complex arguments. These findings provide a novel demonstration that people are intuitively sensitive to logical structure. (shrink)

This essay situates the major works of W.E.B. Du Bois and some of his minor work between the 1880s and 1940 in the historical context of black people's writing about race since the eighteenth century. In offering examples of the evolution of black thinking and writing on this topic, it views Du Bois's work in the context of Moral and Ethical Philosophy (rather than the more obvious History, Sociology, and Political Economics) in order to reveal his efforts as a disruption, (...) deliberately designed to shift the discussions of race and race relations from defense to offense, which he did most explicitly and profoundly in Dusk of Dawn (1940) but had been doing much more subtly throughout his scholarly career. (shrink)

In this paper, I consider a particular amoralist challenge against those who would morally criticize our single-player video play, viz., “come on, it’s only a game!” The amoralist challenge with which I engage gains strength from two facts: the activities to which the amoralist lays claim are only those that do not involve interactions with other rational or sentient creatures, and the amoralist concedes that there may be extrinsic, consequentialist considerations that support legitimate moral criticisms. I argue that the amoralist (...) is mistaken and that there are non-consequentialist resources for morally evaluating our single-player game play. On my view, some video games contain details that anyone who has a proper understanding of and is properly sensitive to features of a shared moral reality will see as having an incorrigible social meaning that targets groups of individuals, e.g., women and minorities. I offer arguments to support the claim that there are such incorrigible social meanings and that they constrain the imaginative world so that challenges like “it’s only a game” lose their credibility. I also argue that our responses to such meanings bear on evaluations of our character, and in light of this fact video game designers have a duty to understand and work against the meanings of such imagery. (shrink)