The White Coats for Black Lives and #ShutDownSTEM movements have galvanised biomedical practitioners and researchers to eliminate institutional and systematic racism, including barriers faced by Black researchers in biomedicine and science, technology, engineering, and mathematics. In our study on Black–White funding gaps for National Institutes of Health Research Project grants, we found that the overall award rate for Black applicants is 55% of that for white applicants. How can systems for allocating research grant funding be made more fair while (...) improving their efficiency? (shrink)

The particular design of any technology may have profound social implications. Computing technologies are deeply intermeshed with the activities of daily life, playing an ever more central role in how we work, learn, communicate, socialize, and participate in government. Despite the many ways they have improved life, they cannot be regarded as unambiguously beneficial or even value-neutral. Recent experience shows they can lead to unintended but harmful consequences. Some technologies are thought to threaten democracy through the spread of propaganda on (...) online social networks, or to threaten privacy through the aggregation of datasets that include increasingly personal information, or to threaten justice when machine learning is used in such high-stakes, decision-making contexts as loan application reviews, employment procedures, or parole hearings. It is insufficient to ethically assess technology after it has produced negative social impacts, as has happened, for example, with facial recognition software that discriminates against people of color and with self-driving cars that are unable to cope with pedestrians who jay-walk. Developers of new technologies should aim to identify potential harmful consequences early in the design process and take steps to eliminate or mitigate them. This task is not easy. Designers will often have to negotiate among competing values—for instance, between efficiency and accessibility for a diverse user population, or between maximizing benefits and avoiding harm. There is no simple recipe for identifying and solving ethical problems. -/- Computer science education can help meet these challenges by making ethical reasoning about computing technologies a central element in the curriculum. Students can learn to think not only about what technology they could create, but also whether they should create that technology. Learning to reason this way requires courses unlike those currently standard in computer science curricula. A range of university courses on topics in areas of computing, ethics, society and public policy are emerging to meet this need. Some cover computer science broadly, while others focus on specific problems like privacy and security; typically, these classes exist as stand-alone courses in the computer science curriculum. Others have integrated ethics into the teaching of introductory courses on programming, artificial intelligence, and human-computer interaction. (shrink)

The development of gene expression profiling and next-generation sequencing technologies have steered oncogenomics to the forefront of precision medicine. This created a need for harmonious cooperation between clinicians and researchers to increase access to precision oncology, despite multiple implementation challenges being encountered. The aim is to apply personalised treatment strategies early in cancer management, targeting tumour subtypes and actionable gene variants within the individual’s broader clinical risk profile and wellbeing. A knowledge-generating database linked to the South African Medical Research Council’s (...) Genomic Centre has been created for the application of personalised medicine, using an integrated service and research approach. Insights gained from patient experiences related to tumour heterogeneity, access to targeted therapies and incidental findings of pathogenic germline variants in tumour DNA, provided practice-changing evidence for the implementation of a cost-minimisation pathology-supported genetic testing strategy. Integrating clinical care with genomic research through data sharing advances personalised medicine and maximises precision oncology benefits. (shrink)

Background and Aims Progress towards validating amyloid beta as an early indicator of Alzheimer’s disease (AD) heightens the need for evaluation of stakeholders’ perspectives of the benefits and harms of preclinical testing in asymptomatic individuals. Methods Investigators conducted and analyzed 14 semi-structured interviews with family members of patients diagnosed with AD. Results Participants reported benefits, including the potential to seek treatment, make lifestyle changes, and prepare for cognitive impairment. Participants identified harms, including social harms, adverse life decisions, and psychological harms. (...) Nine participants reported either a “positive global perspective” or a “positive global perspective (qualified).” Conclusion Results from this study characterized stakeholders’ perspectives on the potential benefits and harms of clinical use of preclinical testing for AD. Investigators used data from this study to develop a framework that contributes to ongoing discussions that will evaluate widespread adoption of preclinical testing and will inform future research. (shrink)

For the successful achievement of evidence-based practice, clinicians, managers and purchasers need evidence on whether a particular intervention works and ways to judge the appropriateness of the outcome criteria and measures used. Guidance is needed on what outcome measure to use, especially within routine clinical care settings. Beginning with a re-clarification of the difference between a health status and an outcome measure, the paper presents an evaluative checklist for use by clinical audit and research staff to review outcome measures for (...) use in routine care settings. Central features include the user-centredness of the measure, its psychometric properties, feasibility of use and utility. The applicability of the checklist is illustrated for outcome measurement in diabetes and stroke care. A modified form of the checklist is proposed for use by the busy clinician as an aid to the critical review of research papers within the context of evidence-based practice and to aid health care practitioners' choice of which outcome measure(s) to use within routine clinical care. (shrink)

We investigate what distinguishes social entrepreneurial ecosystems (SEEs) from entrepreneurial ecosystems (EEs) through appreciation of the importance of context—the multiplex of intertwined social, spatial, temporal, historical, cultural, and political influences. Community is incorporated as a key variable and hitherto overlooked dimension of the structure and influence of SEEs. We draw on extant literature and examples of a variety of SEEs to support our propositions and demonstrate why considerations of both context and community are critical to advance understanding of SEEs. We (...) contribute to the study of SEEs by presenting a new conceptual framework and theorizing SEE as an evolving composite of interdependent actors who interact and collaborate across multiple levels to collectively generate positive externalities and drive sustainable solutions to social problems. (shrink)

Andreas Schmidt argues that ethicists have misplaced moral qualms about nudges insofar as their worries are about whether nudges treat us as rational agents, because nudges can enhance our rational agency. I think that Schmidt is right that nudges often enhance our rational agency; in fact, we can carry his conclusion further: nudges often enhance our self-governing agency, too. But this does not alleviate our worries that nudges fail to treat us as rational. This is shown by disambiguating two conceptions (...) of treating-as-rational. The more plausible conception of treating-as-rational undermines Schmidt’s case that nudges often treat us as rational. (shrink)

We are moral equals, but in virtue of what? The most plausible answers to this question have pointed to our higher agential capacities, but we vary in the degrees to which we possess those capacities. How could they ground our equal moral standing, then? This chapter argues that they do so only indirectly. Our moral equality is most directly grounded in a social practice of equality, a practice that serves the purpose of mitigating our tendencies toward control and domination that (...) interpreters of Rousseau call “inflamed amour-propre.” We qualify as participants in this practice of equality by possessing certain agential capacities, but it is our participation in the practice, and not the capacities themselves, that makes us moral equals. This chapter thus proposes moving from a capacity-based to practice-based view of moral equality. Doing so avoids problems for other accounts that, like the one defended here, ignore (above a threshold) the varying degrees to which we possess the pertinent agential capacities, such as Ian Carter’s account of “opacity respect.”​. (shrink)

This essay explores the intersection of racism, racial embodiment theory and the recent hostility aimed at immigrants and foreigners in the United States, especially the targeting of people of Latin American descent and Latino/as. Anti-immigrant and anti-foreigner sentiment is racist. It is the embodiment of racial privilege for those who wield it and the materiality of racial difference for those it is used against. This manifestation of racial privilege and difference rests upon a redrawing of the color line that is (...) meant towards preserving exclusive categories of political membership. The charge of racism, however, is elided by the fact that this hostility takes the form of a specious embracement of law and lawfulness. “Illegal” in this sense not only captures the actions of those who enter the United States through clandestine or informal means, but, in light of the history of immigration and citizen- ship law, the term operates as a racial trope that designates non-white status, thus marginalizing and alienating certain immigrants from ongoing nation-formation processes. I explain the source for anti-immigrant hostility in the United States, which I take to be connected to the longevity of white normativity as the basis for American identity. I then critically assess how the idea of national belonging is crucial to the perpetuation of white-ways-of-being, especially when citizenship has historically been a venue for the embodiment of racial and even colonial privilege. I conclude by posing several questions about the nature of racial identities and racism that suggest new avenues for further research on racial embodiment in a “postracial” era. pp. 65–90. (shrink)

This work explores the increasing militarization of borders throughout the world, particularly the United States border with Mexico. Rather than further rhetoric of "border security," this work views increases in guards, technology and the building of walls as militarized action. The goal of this essay is to place the onus upon states to justify their actions at borders in ways that do not appeal to tropes of terrorism. This work then explores how a logic of security infiltrates philosophical discussions of (...) "the right to exclude," thereby curtailing the ability to see borders in any other way than as a locale that must be militarized. Specifically, I analyze the work of Michael Blake and his juridical theory of immigration restrictions. I argue that his work necessitates the walling of borders and removal of those who create new obligations for current members of existing political institutions. (shrink)

A central reason to worry that managers should not use nudges to influence employees is that doing so fails to treat employees as _rational_ and/or _autonomous_ (RA). Recent nudge defenders have marshaled a powerful line of response against this worry: in general, nudges treat us as the kind of RA agents we are, because nudges are apt to enhance our limited capacities for RA agency by improving our decision-making environments. Applied to managerial nudges, this would mean that when managers nudge (...) their employees, they generally bolster their employees’ limited RA agency and, thus, treat employees as the kinds of RA agents they are. My aim is to vindicate a qualified version of the initial worry from the nudge-defender response and, as a result, provide a clearer, more plausible framework for evaluating managerial nudges than what nudge critics have previously given. I do this, first, by showing how nudge defenders rely on equivocation between two different senses of “treating someone as RA.” The _value-preserving_ notion that supports the nudge-defender prescription to protect and enhance RA capacities is different from the _authority-recognizing_ notion that underwrites the initial worry about nudging. Second, I argue that the authority-recognizing notion of treating someone as RA implies that managerial nudges treat employees as RA just when the nudges are compatible with relating to employees as equals. Third, I explain how, to determine when managerial nudges are compatible with relating to employees as equals, we need to consider how employees surrender aspects of their equal, agency-grounded authority to managers. (shrink)

This essay explores the extent to which comparative philosophy can assist decolonial struggle. In order to accomplish this task, I offer not only a description of philosophy's colonization but also an account of how this discipline remains subject to the coloniality of knowledge. In short, insofar as race, gender, class, and sexuality are considered irrelevant or accidental to the production of philosophical knowledge, professional philosophy replicates, if not continues, what Rajeev Bhargava terms the epistemic injustice of colonialism. One response to (...) the colonization of philosophy is “diversification” by means of putting into conversation philosophers, systems, and ideas from differing cultures or regions throughout the world. While a step forward, insofar as philosophical comparisons occur primarily on an East–West axis, philosophers are not necessarily addressing the biases, prejudices, racism, and exceptionalism endemic to their discipline. In fact, such a directionality typically reinforces the sense of historical development that undergirds Western philosophy's self‐understanding. This essay, therefore, offers a series of recommendations for how to radicalize comparative philosophical efforts so as to address global epistemic injustice and aid in the process of decolonization. (shrink)

How important is it for managers to have the “nice” virtues of modesty, civility, and humility? While recent scholarship has tended to focus on the organizational consequences of leaders having or lacking these traits, I want to address the prior, deeper question of whether and how these traits are intrinsically morally important. I argue that certain aspects of modesty, civility, and humility have intrinsic importance as the virtues of relational equality – the attitudes and dispositions by which we relate as (...) moral equals. I provide a novel account of the normative grounds of the virtues of relational equality and develop a corresponding framework for how these virtues can be enacted by managers. The virtues are grounded in the value of opposing objectionable forms of social hierarchy, which requires social norms that grant all persons the same personal authority over their lives and interactions. I show how this view of virtue contrasts with prevailing Aristotelian, Personalist, and Smithian views in business ethics. I then explain how, for managers, sustaining and enacting the virtues of relational equality involves a distinctive cluster of role-specific traits: respect for employees’ equal personal authority, a commitment to express such respect, and a disposition to give equal weight and deference to employees’ relevant interests. (shrink)

Why does respect for persons involves accepting that persons have responsibilities, and not just authority, for their lives and interactions? I show how we can answer this question with a role-based view: respect for persons is an attitude of recognizing others for a social role they occupy. To fill in a role-based view, we need to describe the practice into which the pertinent role figures. To do this, my account draws on the Rousseauian idea of inflamed amour-propre. Roughly, respect for (...) persons is an attitude of recognizing persons for the role they occupy in a social practice that helps solve the problem of inflamed amour-propre. (shrink)

When do companies deserve moral credit for doing what is right? This question concerns the positive side of corporate moral responsibility, the negative side of which is the more commonly discussed issue of when companies are blameworthy for doing what is wrong. I offer a broadly functionalist account of how companies can act from morally creditworthy motives, which defuses the following Strawsonian challenge to the claim that they can: morally creditworthy motivation involves being guided by attitudes of “goodwill” for others, (...) and these attitudes involve affect and/or phenomenal consciousness, which corporate agents cannot maintain. In response, I show that what matters about being guided by attitudes of goodwill is being directly concerned for others in one’s practical deliberation. Companies can achieve this direct concern through their decision-making procedures without affect or phenomenal consciousness. I also explore how a company’s moral creditworthiness, or lack thereof, should shape stakeholders’ relationship with it. (shrink)

Guilt poses a unique evolutionary problem. Unlike other dysphoric emotions, it is not immediately clear what its adaptive significance is. One can imagine thriving despite or even because of a lack of guilt. In this article, we review solutions offered by Scott James, Richard Joyce, and Robert Frank and show that although their solutions have merit, none adequately solves the puzzle. We offer an alternative solution, one that emphasizes the role of empathy and posttransgression behavior in the evolution of guilt. (...) Our solution, we contend, offers a better account of why guilt evolved to play its distinctive social role. (shrink)

Case-based, multidisciplinary seminars provided a vehicle for clinicians, philosophers and students to debate current problems in medical ethics in a manner which ensured maximum learning and interest for all participants. Prior training in philosophical medical ethics was an essential prerequisite, giving students the knowledge and skills to take part in the discussions at an appropriate level of sophistication.

The paper begins with a brief statement about the centrality of autonomy or self governance as a core ethical value in the interaction between health care worker and patient. Then there are three stories describing everyday interactions in an acute psychiatric unit. These are used to help unravel ethical issues relating to patient autonomy. Each story is analysed for its ethical components by describing the protagonists' different perspectives, and their reactions to the events. Attention is also paid to institutional policy. (...) Suggestions are made for small changes in both staff behaviour and institutional procedures. Such changes could enhance rather than diminish patient autonomy. (shrink)

This article offers a response to Michael J. Monahan's engagement with and criticism of Grant Silva's article “Racism as Self-Love.” So as to demonstrate how Monahan's idea of “ur-contempt” fits alongside the author's project and supplements his attempt to challenge the variety of forms of moral obfuscation employed by white nationalists and other racists today, this response begins with an overview of the central critique of moral responsibility for racism that Silva's work offers. At stake is the attempt, by (...) unabashed white supremacist and others, to bank on historical acts of racial oppression and reap the benefits of elevated social status while evading responsibility for that past. The goal in this project is thus to demonstrate the entanglement of interpersonal and structural forms of racism while also describing how racism unfolds in the present in order to challenge the types of moral evasion for racism that Monahan and Silva are concerned with. (shrink)

This is an interview with author Lester Grinspoon, M.D., whose work on psychoactive substances over the last thirty‐five years has been highly influential. His book, Marihuana: The Forbidden Medicine (written with James B. Bakalar), is a classic source on the medical marijuana controversy. His books Psychedelic Drugs Reconsidered and Cocaine: A Drug and Its Social Evolution are standards in the field. Dr. Grinspoon received his M.D. from Harvard Medical School and currently is associate professor emeritus at Harvard Medical School. His (...) academic work has also reached a general audience through publications ranging from the New York Times Book Review to Playboy. Describing him as the "complete medical scholar," his citation for the Lindesmith Award for Achievement in the Field of Scholarship also notes, "Lester Grinspoon represents all those scholars who report the results of their research truthfully, despite the political consequences of this unwelcomed honesty.". (shrink)

The ideal of relating as equals is, in part, an ideal of virtue – the attitudes and dispositions that support social relations of equality. These are standardly taken to involve accepting the Equal Authority of other persons, giving other persons Equal Consideration, and treating the interests of other persons as having Equal Importance. But why does relational equality involve these attitudes and dispositions, and what exactly do they entail? I aim to make progress on answering these questions by focusing on (...) adult autonomy, using the workplace as an apt setting for exploring the resulting autonomy-focused conception of relational egalitarian virtue. I first consider and reject an interest- focused conception of relational egalitarian virtue, which treats Equal Importance as central. This view allows for a paternalistic stance that is incompatible with social relations of equality. I then develop an autonomy-focused view that treats Equal Authority as central, what I call the “Authority-Centered Relational Egalitarian” virtue (ACRE). ACRE avoids the paternalistic implications of the interest-focused view. I conclude by exploring how managers can sustain and enact ACRE in exercising organizational authority over employees. (shrink)

Each of the essays collected here presents one or more flashpoints or crises in a history of 20 th - and 21 st -century dwelling.

Unjustifiably expecting a higher form of regard from others than one deserves is a familiar vice; call it the “vanity-vice.” How serious of a vice is it? Rousseau claims that it is uniquely morally dangerous. I show how Rousseau’s claim is true of only one form of the vanity-vice. I first develop an account of dangerous vices that takes seriously Rousseau’s concern about the anti-egalitarian vices associated with inflamed amour-propre. I then apply two, cross-cutting distinctions in vanity: a distinction in (...) whether one cares about the correctness of one’s expectations of high regard, and a distinction in the kind of high regard one expects. When we do not care about the correctness of our inflated expectations of regard, and when the unduly high regard we expect is authority-recognizing deference, we manifest a form of vanity that is uniquely dangerous, what I call “entitled smugness.”. (shrink)

Conferring legal personhood on purely synthetic entities is a very real legal possibility, one under consideration presently by the European Union. We show here that such legislative action would be morally unnecessary and legally troublesome. While AI legal personhood may have some emotional or economic appeal, so do many superficially desirable hazards against which the law protects us. We review the utility and history of legal fictions of personhood, discussing salient precedents where such fictions resulted in abuse or incoherence. We (...) conclude that difficulties in holding “electronic persons” accountable when they violate the rights of others outweigh the highly precarious moral interests that AI legal personhood might protect. (shrink)