Research question and aimClinical Ethics Committees (CECs) aim to support healthcare professionals (HPs) and healthcare organizations to deal with the ethical issues of clinical practice. In 2020,...

BackgroundUnder COVID-19 pandemic, many organizations developed guidelines to deal with the ethical aspects of resources allocation. This study describes the results of an argument-based review of ethical guidelines developed at the European level. It aims to increase knowledge and awareness about the moral relevance of the outbreak, especially as regards the balance of equity and dignity in clinical practice and patient’s care. MethodAccording to the argument-based review framework, we started our research from the following two questions: what are the ethical (...) principles adopted by the ethical guidelines produced at the beginning of the COVID-19 outbreak related to resource allocation? And what are the practical consequences in terms of 'priority' of access, access criteria, management of the decision-making process and patient care?ResultsTwenty-two ethical guidelines met our inclusion criteria and the results of our analysis are organized into 4 ethical concepts and related arguments: the equity principle and emerging ethical theories; triage criteria; respecting patient’s dignity, and decision making and quality of care.ConclusionFurther studies can investigate the practical consequences of the application of the guidelines described, in terms of quality of care and health care professionals’ moral distress. (shrink)

BackgroundThis study aims to quantitatively and qualitatively evaluate the activities of a Bioethics Unit (BU) 5 years since its implementation (2016–2020). The BU is a research unit providing empirical research on ethical issues related to clinical practice, clinical ethics consultation, and ethical education for health care professionals (HPS).MethodsWe performed an explanatory, sequential, mixed-method, observational study, using the subsequent qualitative data to explain the initial quantitative findings. Quantitative data were collected from an internal database and analyzed by descriptive analysis. Qualitative evaluation (...) was performed by semi-structured interviews with 18 HPs who were differently involved in the BU’s activities and analyzed by framework analysis.ResultsQuantitative results showed an extensive increment of the number of BU research projects over the years and the number of work collaborations with other units and wards. Qualitative findings revealed four main themes, concerning: 1. the reasons for contacting the BU and the type of collaboration; 2. the role of the bioethicist; 3. the impact of BU activities on HPs, in terms of developing deeper and more mature thinking; 4. the need to extend ethics support to other settings. Overall, our results showed that performing both empirical bioethics research and more traditional clinical ethics activities at the same unit would produce an impetus to increase collaboration and spread an 'ethical culture' among local HPs.ConclusionsOur findings contribute to a growing body of literature on the models of clinical ethics support services and the role of empirical research in bioethics internationally. They also prepare the ground for the implementation of a multidisciplinary Clinical Ethics Committee (CEC) that aims to support the BU’s ethics consultation service within the local context. (shrink)

Advance care planning (ACP) is considered a pivotal aid in the decision‐making process, especially for many people living with dementia, who inevitably will lose the capacity to make decisions at the end of life. In Italy, ACP has been recently regulated by law 219/2017, leading to the investigation of how physicians deal with ACP in dementia. In order to comprehend the perception of physicians who provide care for patients with dementia regarding ACP and to describe their difficulties and needs, this (...) study presents the results of a qualitative research study performed within a local health authority in northern Italy. Data were collected by semi‐structured interviews with 11 physicians dealing with patients with dementia and were analysed using interpretative phenomenological analysis. Four superordinate themes were identified, describing both the difficulties and challenges perceived by physicians in performing shared ACP in their daily activities. This study demonstrates that physicians experience troubles synchronizing the time of shared ACP with the more rapid development of dementia. Results also suggest that further training about communication on ACP is urgently required to ease the implementation of shared ACP. A broader involvement of institutions and other professionals is also important in spreading ACP among healthcare institutions. (shrink)

Two arguments are offered here for postulating individual essences of concrete individuals on top of their sortal essences. One is the explanatory gap argument, the other draws on the analogy with the individual essences of events presupposed in single causal explanations. These arguments support qualitative individual essences with explanatory goals as opposed to hybrid impure relational essences accounting for origin and numerical identity. It is highlighted why origin properties as parts of impure relational essences do not yield genuine de re (...) constructions. The distinction between the two types of individual essences is traced back to the ambiguity of the very notion of individuation. (shrink)

No mito do Político há elementos da cosmologia, da teologia e da antropologia de Platão. Apresentados em narração mitológica, esses elementos não só não estão em contradição com as perspectivas formuladas em contextos argumentativos, mas ajudam a compreendê-las e interpretálas. Esta comunicação quer mostrar: a) o tempo do mundo na era de Zeus está sob governo de deus; b) o governo de deus não exclui, mas exige a autonomia humana; c) a inserção da ação humana no contexto cósmico é fundamental (...) para o sentido e alcance da autonomia humana; d) a descrição platônica do cosmo é crucial para a compreensão de suas preocupações ético-políticas.In the Statesman myth elements of Platonic cosmology, theology, and anthropology can be found. These elements, although presented in a mythological narrative, are not only not in contradiction with Plato's direct formulations, but also help in the understanding and interpreting of them. This paper aims to show that: a) cosmic time in the age of Zeus is under divine government; b) this divine government does not exclude but requires human autonomy; c) the inclusion of human action in the cosmic context is essential to understanding the meaning and reach of human autonomy; d) Plato's description of the cosmos is crucial to understanding his ethicalpolitical preoccupations. (shrink)

The Fairness, Accountability, and Transparency (FAccT) literature tends to focus on bias as a problem that requires ex post solutions (e.g. fairness metrics), rather than addressing the underlying social and technical conditions that (re)produce it. In this article, we propose a complementary strategy that uses genealogy as a constructive, epistemic critique to explain algorithmic bias in terms of the conditions that enable it. We focus on XAI feature attributions (Shapley values) and counterfactual approaches as potential tools to gauge these conditions (...) and offer two main contributions. One is constructive: we develop a theoretical framework to classify these approaches according to their relevance for bias as evidence of social disparities. We draw on Pearl’s ladder of causation (Causality: models, reasoning, and inference. Cambridge University Press, Cambridge, 2000, Causality, 2nd edn. Cambridge University Press, Cambridge, 2009. https://doi.org/10.1017/CBO9780511803161) to order these XAI approaches concerning their ability to answer fairness-relevant questions and identify fairness-relevant solutions. The other contribution is critical: we evaluate these approaches in terms of their assumptions about the role of protected characteristics in discriminatory outcomes. We achieve this by building on Kohler-Hausmann’s (Northwest Univ Law Rev 113(5):1163–1227, 2019) constructivist theory of discrimination. We derive three recommendations for XAI practitioners to develop and AI policymakers to regulate tools that address algorithmic bias in its conditions and hence mitigate its future occurrence. (shrink)

A complete, illustrated survey of Etienne-Jules Marey's work that investigates the far reaching effects of her inventions on stream-of-consciousness literature, psychoanalysis, Bergsonian philosophy, and the art of cubists and futurists.

This paper examines a little studied type of perspective shift that I call protagonist projection, following Holton :625–628, 1997). PP is a way of describing the mental state of a protagonist that conveys, to some extent, her perspective. Similarly to its better known cousin free indirect discourse, the shift in perspective is achieved without an overt operator. Unlike FID, PP is not based on a presumed speech-act of a protagonist. Rather, it gives a linguistic form to pre-verbal perceptual content, sensations, (...) feelings or implicit beliefs. I propose to analyse PP in a bi-contextual framework, extending Eckardt’s approach to FID. Under the resulting analysis, FID and PP are two instances of a more general category of perspective shift. (shrink)

The central idea behind this paper is that presuppositions of soft triggers arise from the way our attention structures the informational content of a sentence. Some aspects of the information conveyed are such that we pay attention to them by default, even in the absence of contextual information. On the other hand, contextual cues or conversational goals can divert attention to types of information that we would not pay attention to by default. Either way, whatever we do not pay attention (...) to, be it by default, or in context, is what ends up presupposed by soft triggers. This paper attempts to predict what information in the sentence is likely to end up being the main point (i.e. what we pay attention to) and what information is independent from this, and therefore likely presupposed. It is proposed that this can be calculated by making reference to event times. The notion of aboutness used to calculate independence is based on that of Demolombe and Fariñas del Cerro (In: Holdobler S (ed) Intellectics and computational logic: papers in honor of Wolfgang Bibel, 2000). (shrink)

In this paper I show that a novel ontic reading of explanation, intending to capture the de re essential features of individuals, can support the qualitative view of individual essences. It is argued further that the putative harmful consequences of the Leibniz Principle and its converse for the qualitative view can be avoided, provided that individual essences are not construed in the style of the naïve bundle theory with set-theoretical identity- conditions. Adopting either the more sophisticated two-tier BT or, alternatively, (...) the neo-Aristotelian position of taking essences as natures in the Aristotelian sense, can help to evade these main charges against the qualitative view. The functional parallels with the alternative haecceitistic view of individuation and individual essence will also be considered. (shrink)

Some presuppositions are easier to cancel than others in embedded contexts. This contrast has been used as evidence for distinguishing two fundamentally different kinds of presuppositions, ‘soft’ and ‘hard’. ‘Soft’ presuppositions are usually assumed to arise in a pragmatic way, while ‘hard’ presuppositions are thought to be genuine semantic presuppositions. This paper argues against such a distinction and proposes to derive the difference in cancellation from inherent differences in how presupposition triggers interact with the context: their focus sensitivity, anaphoricity, and (...) question–answer congruence properties. The paper also aims to derive the presuppositions of additive particles such as too, also, again, and of it-clefts. (shrink)

The relationship between philosophy and science has always been complementary. Today, while science moves increasingly fast and philosophy shows some problems in catching up with it, it is not always possible to ignore such relationships, especially in some disciplines such as philosophy of mind, cognitive science, and neuroscience. However, the methodological procedures used to analyze these data are based on principles and assumptions that require a profound dialogue between philosophy and science. Following these ideas, this work aims to raise the (...) problems that a classical connectionist theory can cause and problematize them in a cognitive framework, considering both philosophy and cognitive sciences but also the disciplines that are near to them, such as AI, computer sciences, and linguistics. For this reason, we embarked on an analysis of both the computational and theoretical problems that connectionism currently has. The second aim of this work is to advocate for collaboration between neuroscience and philosophy of mind because the promotion of deeper multidisciplinarity seems necessary in order to solve connectionism’s problems. In fact, we believe that the problems that we detected can be solved by a thorough investigation at both a theoretical and an empirical level, and they do not represent an impasse but rather a starting point from which connectionism should learn and be updated while keeping its original and profoundly convincing core. (shrink)

A discussion concerning whether to conceive Artificial Intelligence systems as responsible moral entities, also known as “artificial moral agents”, has been going on for some time. In this regard, we argue that the notion of “moral agency” is to be attributed only to humans based on their autonomy and sentience, which AI systems lack. We analyze human responsibility in the presence of AI systems in terms of meaningful control and due diligence and argue against fully automated systems in medicine. With (...) this perspective in mind, we focus on the use of AI-based diagnostic systems and shed light on the complex networks of persons, organizations and artifacts that come to be when AI systems are designed, developed, and used in medicine. We then discuss relational criteria of judgment in support of the attribution of responsibility to humans when adverse events are caused or induced by errors in AI systems. (shrink)

Cases—be they real or fictional—are commonplace both in the medical ethics literature and in the public media. Cases take on a variety of forms: from streamlined to book length narratives. They also serve a variety of different purposes, from illustration, to decision making, and from debunking to heuristics. Drawing on the rhetorical analysis of « exemplum », I shall describe what cases are, and what their role is in the practice of clinical ethics. I identify two basic ways in which (...) cases can be brought to bear on ethical thinking and practice: a « tamed » and a « wild » way, and show how « wild cases » can serve a useful heuristic function despite their appeal to emotions and their unusual and striking character. In conclusion, I will argue that cases, both in their wild and their tamed form, are not only useful pedagogical tools, but can serve as a legitimate empirical basis for medical ethics. (shrink)

Cancer research is experiencing ‘paradigm instability’, since there are two rival theories of carcinogenesis which confront themselves, namely the somatic mutation theory and the tissue organization field theory. Despite this theoretical uncertainty, a huge quantity of data is available thanks to the improvement of genome sequencing techniques. Some authors think that the development of new statistical tools will be able to overcome the lack of a shared theoretical perspective on cancer by amalgamating as many data as possible. We think instead (...) that a deeper understanding of cancer can be achieved by means of more theoretical work, rather than by merely accumulating more data. To support our thesis, we introduce the analytic view of theory development, which rests on the concept of plausibility, and make clear in what sense plausibility and probability are distinct concepts. Then, the concept of plausibility is used to point out the ineliminable role played by the epistemic subject in the development of statistical tools and in the process of theory assessment. We then move to address a central issue in cancer research, namely the relevance of computational tools developed by bioinformaticists to detect driver mutations in the debate between the two main rival theories of carcinogenesis. Finally, we briefly extend our considerations on the role that plausibility plays in evidence amalgamation from cancer research to the more general issue of the divergences between frequentists and Bayesians in the philosophy of medicine and statistics. We argue that taking into account plausibility-based considerations can lead to clarify some epistemological shortcomings that afflict both these perspectives. (shrink)

The chapter provides an analysis of the concept of the dignity of the person in Polish legal culture. It begins with a brief description of the historical background in which the legal status of human dignity has been framed. Then it turns to the analysis of the philosophical doctrines which have shaped the concept, in particular those which influenced Polish legal scholarship to the highest degree. The subsequent section attempts to clarify the meaning of the concept, specifying its features and (...) providing distinctions between dignity of the person and dignity of personage. Finally, the chapter presents the protection and respect of the dignity of the person in Polish legislation. (shrink)

Academic mobility is usually perceived and discussed as a positive phenomenon — as a prerequisite for building a competitive and successful economy and quality science. Academic mobility has now become essential to building a successful academic career in many research domains. On the policy level the negative impact of academic mobility on researchers’ lives and especially women’s is usually overlooked and marginalized. In my paper I focus on academic mobility in the context of academics’ relationships and family lives. I ask (...) two research questions: What is the impact of mobility on researchers’ relationships? How does mobility affect the lives of the partners of mobile researchers? The analysis is based on i) 16 in-depth interviews with academics from various fields of research about their experiences of long-term fellowships abroad in the early stages of their academic path and on ii) 16 in-depth joint interviews with Czech dualcareer academic couples. The analysis shows that academic mobility has a great and significant impact on the family and partnership lives of migrating researchers. For many, especially the partners of migrating researchers, mobility means they have to make many concessions in their private and family lives. I conclude that the impact of academic mobility on people’s partnership lives is highly gendered because couples’ work and family lives are closely intertwined. (shrink)

This book presents a novel interpretation of Aristotle's account of how shame instils virtue, and defends its philosophical import. Shame is shown to provide motivational continuity between the actions of the learners and the virtuous dispositions that they will eventually acquire.

In March 2016, DeepMind's computer programme AlphaGo surprised the world by defeating the world‐champion Go player, Lee Sedol. AlphaGo exhibits a novel, surprising and valuable style of play and has been recognised as “creative” by the artificial intelligence (AI) and Go communities. This article examines whether AlphaGo engages in creative problem solving according to the standards of comparative psychology. I argue that AlphaGo displays one important aspect of creative problem solving (namely mental scenario building in the form of Monte Carlo (...) tree search), while lacking another (domain generality). This analysis has consequences for how we think about creativity in humans and AI. (shrink)

While inanimate objects can neither experience nor express emotions, in principle they can be expressive of emotions. In particular, music is a paradigmatic example of something expressive of emotions that surely cannot feel anything at all. The Contour theory accounts for music expressiveness in terms of those resemblances that hold between its external and perceivable properties and the typical contour of human emotional behavior. Provided that some critical aspects are emended – notably, the stress on the perception of similarity instead (...) of the more plausible hypothesis that the listener perceives manifestations that are similar – we are inclined to endorse contour theory. In particular, we share its basic idea that expressive properties are perceived. Although other kinds of processes – high-level conceptual inferences, imagination – sometimes characterize our encounters with music, still perception constitutes the standard process underlying the detection of expressiveness. Moreover, we propose to extend contour theory to visual arts. Taking into consideration, as a case study, depicted landscapes, we observe that they frequently cannot but express emotions such as joy, sadness, liveliness or melancholy. The fact that pictures, unlike music, lack any temporal dimension is a prima facie reason for doubting the extendibility of contour theory’s conceptual arsenal to them. Nevertheless, while being obviously unable to behave somehow, we claim that depicted landscapes can perfectly convey dynamic information. If this is the case, the extension of the notion of contour to visuals art via the stress on the notion of dynamism would represent a second interesting revision of contour theory. (shrink)

Animal minds are complex and diverse, making them difficult to study. This Element focuses on a question that has received much attention in the field of comparative cognition: 'Do animals reason about unobservable variables like force and mental states?' The Element shows how researchers design studies and gather evidence to address this question. Despite the many virtues of current methods, hypotheses in comparative cognition are often underdetermined by the empirical evidence. Given this, philosophers and scientists have recently called for additional (...) behavioral constraints on theorizing in the field. The Element endorses this proposal (known as 'signature testing'), while also arguing that studies on animal minds would benefit from drawing more heavily on neuroscience and biology. (shrink)

Business Ethics: A European Review, EarlyView.

A natural landscape can look serene, a shade of colour cheerful and a piece of music might sound heartrending. Why do we ascribe affective qualities to objects that can't entertain psychological states? The capacity that objects, and especially artworks, have to express affective states is a bizarre phenomenon that needs to be clarified in numerous respects. Philosophers are still struggling with the phenomenon of expressiveness being a matter of imagination, perception, or mnemonic association, and usually do not agree on the (...) role that emotions and human bodily expressions play in it. Benenti questions the main theories that populate the aesthetics domain using the tools of philosophy of mind. This study deals with crucial debates concerning seeing-in, cognitive penetration, the relation between phenomenal character and representational content and between emotions and expressions. It aims at providing a viable account of the experience we have of expressive properties by casting light on its fundamentally perceptual nature. The outcome is an empirically informed and critical overview of a topic which has been rather neglected in the philosophy of mind. The book will be of interest to scholars of the philosophy of mind, aesthetics, the cognitive sciences, and psychology. (shrink)

Aristotle ’s claim that we become virtuous by doing virtuous actions raises a familiar problem: How can we perform virtuous actions unless we are already virtuous? I reject deflationary accounts of the answer given in _Nicomachean Ethics_ 2.4 and argue instead that proper habituation involves doing virtuous actions with the right motive, i.e. for the sake of the noble, even though learners do not yet have virtuous dispositions. My interpretation confers continuity to habituation and explains in a non-mysterious way how (...) we become virtuous by doing virtuous actions in the right way. (shrink)

Hélène Cixous is more than an influential theorist. She is also a groundbreaking author and playwright. Combining an idiosyncratic mix of autobiographical and fictional narrative with a host of philosophical and poetic observations, Cixous's writing matches the kaleidoscopic nature of her thought, offering new ways of conceptualizing sex, relationships, identity, and the self, among other topics. Yet, as Jacques Derrida once observed, a "profound misunderstanding" hangs over the accomplishments of Cixous, with many believing the intellectual excelled only at theoretical exploration. (...) Providing a truly liberal selection of her writings from throughout her career, Marta Segarra rediscovers Cixous's acts of invention for a new generation to enjoy. Divided into thematic concerns, these works fully capture Cixous's genius for merging fiction, theory, and the experience of living. They discuss dreaming in the feminine, Algeria and Germany, love and the other, the animal, Derrida, and the theater. They defy classification, locking literature, philosophy, and psychoanalysis into thrilling new patterns of engagement. Whether readers are familiar with Cixous or are approaching her thought for the first time, all will find fresh perspectives on gender, fiction, drama, philosophy, religion, and the postcolonial. (shrink)

Perin argues that theSceptic is engaged in the search for truth and that since this is so, the Sceptic aims to satisfy certain basic rational requirements.

In this paper we focus on a kind of perceptual states that we call perceptual motivations, that is, perceptual experiences that plausibly motivate us to act, such as itching, perceptual salience and pain. Itching seems to motivate you to scratch, perceiving a stimulus as salient seems to motivate you to attend to it and feeling a pain in your hand seems to motivate actions such as withdrawing from the painful stimulus. Five main accounts of perceptual motivation are available: Descriptive, Conative, (...) Imperativist, Reflexive and Dual Content views. Some of these have been developed in detail and others are natural extensions of existing views. However, we argue that none provides a satisfactory account of the target perceptual states. Driven by the failings of each account, we identify three conditions that any satisfactory theory of perceptual motivation must meet: Direct Motivational Force, Non-Obligatory Force and Intention-Independent Influence. Then we offer an account that attempts to fulfil these conditions: the Affordance Model. This model of perceptual motivation is premised on the claim that each of the target states involves the perception of a specific affordance for action and the triggering of Automatic Motor Initiations (AMIs). We suggest that AMIs can explain the motivational force of these perceptual states. (shrink)

Since the 1970s, the origin of cancer is being explored from the point of view of the Somatic Mutation Theory (SMT), focusing on genetic mutations and clonal expansion of somatic cells. As cancer research expanded in several directions, the dominant focus on cells remained steady, but the classes of genes and the kinds of extra-genetic factors that were shown to have causal relevance in the onset of cancer multiplied. The wild heterogeneity of cancer-related mutations and phenotypes, along with the increasing (...) complication of models, led to an oscillation between the hectic search of 'the' few key factors that cause cancer and the discouragement in face of a seeming 'endless complexity'. To tame this complexity, cancer research started to avail itself of the tools that were being developed by Systems Biology. At the same time, anti-reductionist voices began claiming that cancer research was stuck in a sterile research paradigm. This alternative discourse even gave birth to an alternative theory: the Tissue Organization Field Theory (TOFT). A deeper philosophical analysis shows the serious limits of both reductionist and anti-reductionist positions and of their polarization. This book demonstrates that a radical philosophical reflection is necessary to drive cancer research out of its impasses. At the very least, this will be a reflection on the assumptions of different kinds of cancer research, on the implications of what cancer research has been discovering over 40 years and more, on a view of scientific practice that is most able to make sense of the cognitive and social conflicts that are seen in the scientific community (and in its results), and, finally, on the nature of living entities with which we entertain this fascinating epistemological dance that we call scientific research. The proposed Dynamic and Relational View of carcinogenesis is a starting point in all these directions. (shrink)