Background The ethical governance of Artificial Intelligence (AI) in health care and public health continues to be an urgent issue for attention in policy, research, and practice. In this paper we report on central themes related to challenges and strategies for promoting ethics in research involving AI in global health, arising from the Global Forum on Bioethics in Research (GFBR), held in Cape Town, South Africa in November 2022. Methods The GFBR is an annual meeting organized by the World Health (...) Organization and supported by the Wellcome Trust, the US National Institutes of Health, the UK Medical Research Council (MRC) and the South African MRC. The forum aims to bring together ethicists, researchers, policymakers, research ethics committee members and other actors to engage with challenges and opportunities specifically related to research ethics. In 2022 the focus of the GFBR was “Ethics of AI in Global Health Research”. The forum consisted of 6 case study presentations, 16 governance presentations, and a series of small group and large group discussions. A total of 87 participants attended the forum from 31 countries around the world, representing disciplines of bioethics, AI, health policy, health professional practice, research funding, and bioinformatics. In this paper, we highlight central insights arising from GFBR 2022. Results We describe the significance of four thematic insights arising from the forum: (1) Appropriateness of building AI, (2) Transferability of AI systems, (3) Accountability for AI decision-making and outcomes, and (4) Individual consent. We then describe eight recommendations for governance leaders to enhance the ethical governance of AI in global health research, addressing issues such as AI impact assessments, environmental values, and fair partnerships. Conclusions The 2022 Global Forum on Bioethics in Research illustrated several innovations in ethical governance of AI for global health research, as well as several areas in need of urgent attention internationally. This summary is intended to inform international and domestic efforts to strengthen research ethics and support the evolution of governance leadership to meet the demands of AI in global health research. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Summaries and CommentsElizabeth C. Shaw, Staff*, and James ChamberlainBAGGINI, Julian. The Great Guide: What David Hume Can Teach Us about Being Human and Living Well. Princeton, N.J.: Princeton University Press, 2021. 319 pp. Cloth, $24.95; paper, $19.95Throughout this engaging and accessible book, Julian Baggini encourages his readers to treat the life and works of David Hume as a "model of how to live." Baggini presents summaries of (...) Hume's most famous philosophical arguments, along with biographical details about Hume's life, but always with the aim of learning from Hume about living well. He also discusses his own visits to several locations of importance to Hume.Over the course of The Great Guide, Baggini suggests many "Humean maxims and aphorisms" related to the good life. Some are drawn from Hume's own writings, such as the maxim that "the greatest part of mankind float betwixt vice and virtue." Others are arrived at by considering aspects of Hume's own life and character, including his failings. For example, after considering Hume's racism, Baggini clearly has his own admiration for Hume in mind when he suggests the maxim "never slavishly follow even the greatest minds, for they too have prejudices, weaknesses, and blind spots."Baggini begins by describing those parts of Edinburgh and southern Scotland that Hume would have known in his youth. He recounts the young Hume's rejection of religious belief and of the Stoic project of attempting to find happiness by making oneself independent of others. However, Baggini notes, Hume never rejected the racist views he expressed in his essay "Of National Characters." Baggini argues that, although we should condemn Hume's views, we should treat his possession of these views primarily as evidence of the extent to which we are all socially conditioned. In Baggini's view, Hume's empiricist commitments are such that, were he to be alive today, experience would lead him to reject racism. Baggini thus aims to excuse Hume, at least somewhat, without excusing his racism.In chapter 2, Baggini follows Hume to La Flèche, in France's Loire valley, where Hume wrote most of his Treatise of Human Nature. As well as providing an account of Hume's time there, Baggini summarizes Hume's arguments about miracles, reason, and causation. He approvingly [End Page 809] notes Hume's skeptical conclusions concerning miracles, which he takes to demonstrate Hume's insistence on philosophizing only about the world as it really is. Baggini treats Hume's conclusions about cause and effect as significantly less skeptical. Although he observes that some scholars deny this, Baggini understands Hume to assert that causation is a "real power." His is a clear and helpful introduction to Hume's arguments concerning cause and effect, but readers of the relevant passages might hope for a little more discussion of what certainly appear to be Hume's skeptical claims about causal powers.Chapter 3 examines Hume's arguments about free will and personal identity, via a discussion of the complex factors which shaped his identity as a man of letters. Baggini observes Hume's sociability and his satisfaction in his success. He also commends Hume's broad-minded approach to philosophy and his willingness to write a wide variety of essays and, eventually, historical works.In chapter 4, Baggini discusses Hume's relationship with Paris. Returning to the topic of Hume's broad understanding of philosophy, Baggini argues that many of Hume's greatest insights were psychological ones. By comparing Hume's views on religion with the fervent atheism of the French philosophes, Baggini admiringly stresses Hume's moderation and his denial of any knowledge about "the ultimate ground of being." Since Hume believed he knew no more about the origins of the universe than anyone else, Baggini argues, he was able to develop friendships with and respect for moderate religious thinkers, as many philosophes were not. However, Baggini also suggests that Hume's "conservative instincts" sometimes led him astray, as where he "broadly endorsed the patriarchal attitudes of his time."Chapter 5 begins with an account of the dispute between Hume and Jean-Jacques Rousseau, which then forms the background for a discussion... (shrink)

The ethical review of research using methods of artificial intelligence and machine learning in health care contexts has become an important challenge for Research Ethics Boards (also refer...

The goal of this book is to develop a new approach to reading the rule-following sections guided by a simple idea. The simple idea is that Wittgenstein's remarks on rule-following are split between two distinct but complementary projects. The projects are marked not only by different guiding questions, but different presuppositions and methodologies. There is of course precedent for reading the rule-following remarks as comprising two parts. For example, there is the reading of (S. Kripke 1982) on which Wittgenstein first (...) presents a skeptical challenge before turning to its skeptical solution. And there are readings like (Minar 2011) and (Goldfarb 2012) that likewise treat the sections as roughly divided into two components or "chapters." But even these commentators do not explicitly associate their components with different questions and associated methodologies, and so fall short of attributing to Wittgenstein's text anything quite like the thoroughgoing bipartite structure I will be proposing here. (shrink)

Blackmail raises a pair of parallel legal and moral problems, sometimes referred to as the "paradox of blackmail". It is sometimes legal and morally permissible to ask someone for money, or to threaten to release harmful information about them, while it is illegal and morally impermissible to do these actions jointly. I address the moral version of this paradox by bringing instances of blackmail under a general account of wrongful coercion. According to this account, and contrary to the appearances which (...) give rise to the paradox, threatening the release of harmful information to constrain another's actions is almost never morally impermissible unless it is likewise impermissible to carry out one's threat. To defend this claim I identify a special wrong that arises in the paradoxical cases of threatened information release. The account also resolves a number of other puzzles about blackmail—for example, why profiting from a threat in blackmail can sometimes be impermissible, even though accepting identical payment from an independent offer to retain the same information can be permissible. (shrink)

Philosophy and Phenomenological Research, EarlyView.

De se exceptionalism is the view, notably championed by Perry (1979) and Lewis (1979), that our characteristically 'first-personal' ways of thinking about ourselves present unique challenges to standard views of propositional attitudes like belief. Though the view has won many adherents, it has recently come under a barrage of deserved criticism. A key claim of detractors is that classic examples used to motivate de se exceptionalism from de se ignorance or misidentification are nothing more than familiar Frege-puzzles, which raise no (...) issues exclusive to self-directed thought. After reviewing how this simple objection has substantial force against the classic defenses of exceptionalism, I provide new arguments based on cases of pure de se ignorance that avoid the criticism. Afterward, I revisit Lewis's defense of exceptionalism, diagnosing how he arrived at roughly the right conclusions on the basis of an argument that begged critical questions and obscured the representationally unique features of the de se. (shrink)

Truth-value gaps have received little attention from a foundational perspective, a fact which has rightfully opened up gap theories to charges of vacuousness. This paper develops an account of the foundations of gap-like behavior which has some hope of avoiding such charges. I begin by reviewing and sharpening a powerful argument of Dummett’s to constrain the options that gap theorists have to make sense of their views. I then show that within these strictures, we can give an account of gaps (...) by drawing on elements of a broadly Stalnakerian framework for assertion and using gaps to track an amalgamation of assertoric effects. The discussion reveals that we may need special resources in our theories of assertion to posit gaps, that gaps may be unusable in characterizing the structure of mental states, and that gaps may have heterogeneous linguistic sources that result in equally heterogeneous projective and inferential behavior. (shrink)

I argue that on very weak assumptions about truth (in particular, that there are coherent norms governing the use of "true"), there is a proposition absolutely inexpressible with conventional language, or something very close. I argue for this claim "constructively": I use a variant of the Berry Paradox to reveal a particular thought for my readership to entertain that very strongly resists conventional expression. I gauge the severity of this expressive limitation within a taxonomy of expressive failures, and argue that (...) despite its strength there is nothing incoherent about admitting its existence. The argument forms part of a project of clarifying precisely what trade-offs are required to secure the kinds of expressive power truth theorists typically want, in the process showing that the admission of very strong expressive limitations may ultimately prove to be the lesser of two evils. (shrink)

The Sleeping Beauty puzzle has dramatized the divisive question of how de se beliefs should be integrated into formal theories of rational belief change. In this paper, I look ahead to a related question: how should de se beliefs be integrated into formal theories of rational choice? I argue that standard decision theoretic frameworks fail in special cases of de se uncertainty, like Sleeping Beauty. The nature of the failure reveals that sometimes rational choices are determined independently of one’s credences (...) in the kinds of ‘narrow’ de se propositions that Sleepy Beauty has set in relief. Consequently, in addition to pinpointing a failure of standard decision theoretic frameworks, this result casts doubt on a large class of strategies for determining principles for the rationally updating de se beliefs in cases like Sleeping Beauty, and also calls into question the importance of making such a determination at all. (shrink)

I argue for two theses about semantically anomalous utterances (more commonly called "category mistakes") like "sequestered slaps reel evergreen rights". First, semantic anomaly generates a unique form of semantically enforced quantifier domain restriction. Second, the best explanation for why anomaly interacts with quantifiers in this way is that anomalous utterances are truth-valueless. After arguing for these points, I trace out two consequences these theses have in semantics and logic. First, I argue they motivate a trivalent semantics on which truth-valueless material (...) has an unsual positive role to play in the compositional semantics of truth-evaluable utterances. Second, I argue that the interaction of anomaly with quantifiers generates a unique form of classical inference failure, and also provides special motivations for reconceptualizing our logical consequence relations. (shrink)

The inclusion of members of structurally marginalized communities in data-intensive innovation initiatives, such as precision medicine projects, is an urgent contemporary issue. On the one hand, th...

We describe an evaluation undertaken on contract for the New Zealand State Services Commission of a major project (the Administrative Decision-Making Skills Project) designed to produce a model of administrative decision making and an associated teaching/learning packagefor use by government officers. It describes the evaluation of a philosophical model of decision making and the associated teaching/learning package in the setting of the New Zealand Public Service, where a deliberate attempt has been initiated to improve the quality of decision making, especially (...) in relation to moral factors. (shrink)

Cumming (2008) uses a puzzle about belief ascription to argue against a Millian semantics, and in favor of a semantics on which names are assigned denotations relative to a shiftable variable assignment. I use Cumming's puzzle to showcase the virtues of a rival, broadly Stalnakerian, treatment of attitude ascriptions that safeguards Millianism. I begin by arguing that Cumming's solution seems unable to account for substitutivity data that helps constitute the very puzzle he uses to motivate his account. Once the substitutivity (...) data is acknowledged, the puzzle actually seems to strengthen, rather than weaken, the Millian position. I then argue that the real force of the puzzle is to place special constraints on our accounts of de re belief ascription. To help bring out the nature of those constraints, I connect aspects of Cumming's puzzle to more familiar problems about belief ascription raised by Quine. I then defend three theses making up a skeletal account of de re belief ascription that promises to cope naturally with the variants of Cumming's puzzle, and integrate them into a broader theory of de re intensionality. (shrink)

In Category Mistakes, Ofra Magidor provides two arguments against the view that category mistakes express propositions that are not truth-evaluable at some world. I argue that her first, Williamsonian argument against this view begs the question, and that her second argument rests on a misleading conception of how semantic defect results in infelicity judgments. I conclude by conceding that she is still correct to stress that the view she opposes face noteworthy foundational and empirical challenges.

Black Mirror is a cultural phenomenon. It is a creative and sometimes shocking examination of modern society and the improbable consequences of technological progress. The episodes - typically set in an alternative present, or the near future - usually have a dark and satirical twist that provokes intense question both of the self and society at large. These kind of philosophical provocations are at the very heart of the show. Philosophical reflections on Black Mirror draws upon thinkers such as Friedrich (...) Nietzsche, Pierre Hadot and Michel Foucault to uncover how Black Mirror acts as 'philosophical television' questioning human morality and humanity's vulnerability when faced with the inexorable advance of technology. (shrink)

Applications of artificial intelligence/machine learning in health care are dynamic and rapidly growing. One strategy for anticipating and addressing ethical challenges related to AI/ml for health care is patient and public involvement in the design of those technologies – often referred to as ‘co-design’. Co-design has a diverse intellectual and practical history, however, and has been conceptualized in many different ways. Moreover, AI/ml introduces challenges to co-design that are often underappreciated. Informed by perspectives from critical data studies and critical digital (...) health studies, we review the research literature on involvement in health care, and involvement in design, and examine the extent to which co-design as commonly conceptualized is capable of addressing the range of normative issues raised by AI/ml for health care. We suggest that AI/ml technologies have amplified and modified existing challenges related to patient and public involvement, and created entirely new challenges. We outline three pitfalls associated with co-design for ethical AI/ml for health care and conclude with suggestions for addressing these practical and conceptual challenges. (shrink)

This volume is fourth in the series of annuals created under the auspices of The Association for Feminist Ethics and Social Theory . The topics covered herein_from peacekeeping and terrorism, to sex trafficking and women's paid labor, to poverty and religious fundamentalism_are vital to women and to feminist movements throughout the world.

Background Our objective was to evaluate whether the description of a machine learning (ML) app or brain imaging technology to predict the onset of schizophrenia or alcohol use disorder (AUD) influences healthcare professionals’ judgments of stigma, empathy, and compassion.Methods We randomized healthcare professionals (N = 310) to one vignette about a person whose clinician seeks to predict schizophrenia or an AUD, using a ML app, brain imaging, or a psychosocial assessment. Participants used scales to measure their judgments of stigma, empathy, (...) and compassion.Results Participants randomized to the ML vignette endorsed less anger and more fear relative to the psychosocial vignette, and the brain imaging vignette elicited higher pity ratings. The brain imaging and ML vignettes evoked lower personal responsibility judgments compared to the psychosocial vignette. Physicians and nurses reported less empathy than clinical psychologists.Conclusions The use of predictive technologies may reinforce essentialist views about mental health and substance use that may increase specific aspects of stigma and reduce others. (shrink)

A variety of approaches have appeared in academic literature and in design practice representing “ethics-first” methods. These approaches typically focus on clarifying the normative dimensions of design, or outlining strategies for explicitly incorporating values into design. While this body of literature has developed considerably over the last 20 years, two themes central to the endeavour of ethics and values in design (E + VID) have yet to be systematically discussed in relation to each other: (a) designer agency, and (b) the (...) strength of normative claims informing the design process. To address this gap, we undertook a structured review of leading E + VID approaches and critiques, and classified them according to their positions on normative strength, and views regarding designer agency. We identified 18 distinct approaches and 13 critiques that met the inclusion criteria for our review. Included papers were distributed across the spectrum of views regarding normative strength, and we found that no approaches and only one critique represented a view characteristic of “low” designer agency. We suggest that the absence of “low” designer agency approaches results in the neglect of crucial influences on design as targets of intervention by designers. We conclude with suggestions for future research that might illuminate strategies to achieve ethical design in information mature societies, and argue that without attending to the tensions raised by balancing normatively “strong” visions of the future with limitations imposed on designer agency in corporate-driven design settings, “meaningful” ethical design will continue to encounter challenges in practice. (shrink)

Qualitative and quantitative research on the impact of medical and health humanities teaching in baccalaureate education is sparse. This paper reviews recent studies of the impact of medical and health humanities coursework in pre-health professions education and describes a pilot study of baccalaureate students who completed semester-long medical humanities courses in the Division of Medical Humanities & Bioethics at the University of Rochester. The study format was an email survey. All participants were current or former baccalaureate students who had (...) taken one or more courses in literature and narrative in medicine, bioethics, history of medicine, and/or visual arts and healthcare during the past four years. The survey gathered numerical data in several areas: demographic information, career plans, self-reported influence of coursework on educational and career plans, and self-reported influence of coursework on intellectual skills and abilities. It also gathered narrative commentary that elaborated on students’ responses to the numerically-based questions. Notable findings from preliminary analysis of the data include higher scores of self-reported impact of the coursework on specific habits of mind and on preparedness for intended career rather than on gaining admission to future educational programs. Discussion of the results focuses on several potential future directions this type of study might take, including multi-center, longitudinal, and sequential approaches. (shrink)

In the past 250 years, David Hume probably had a greater impact on the field of philosophy of religion than any other single philosopher. He relentlessly attacked the standard proofs for God's existence, traditional notions of God's nature and divine governance, the connection between morality and religion, and the rationality of belief in miracles. He also advanced radical theories of the origin of religious ideas, grounding such notions in human psychology rather than in divine reality. In the last decade of (...) his life Hume wrote 'I cou'd cover the Floor of a large Room with Books and Pamphlets wrote against me'. Indeed, most of these targeted his writings on religion. This, the third part of the Early Responses to Hume series, and perhaps the most eagerly awaited, collects responses to Hume's writings on religion published during his life, namely, 'Of Miracles', 'Of a Particular Providence and a Future State', The Natural History of Religion , and the posthumously published works Dialogues Concerning Natural Religion , 'Of Suicide' and 'Of the Immortality of the Soul'. The set covers a wide range of the replies Hume's writings provoked, including contributions by Philip Skelton, William Adams, Thomas Rutherforth, William Warburton, Anthony Ellys, John Douglas, John Leland, Thomas Stona, Voltaire, George Campbell, Herman Andrew Pistorius, Duncan Shaw, William Samuel Powell, Thomas Hayter, Joseph Milner, William Paley, Charles Moore, Richard Joseph Sulivan, John Hey, Samuel Vince, Lord Brougham and Thomas De Quincey. (shrink)

Michael A. PetersBeijing Normal UniversityMy deepest condolences to Pepe, Dom and Marcus and to Jim’s grandchildren. Tina and I spent a lot of time at the Marshall family home, often attending dinn...

Pragmatism may be the aspect of William James’s thought for which he is best known; but, at the same time, James’s pragmatism may be among the most misunderstood doctrines of the past century. There are many meanings of word “pragmatism,” even within James’s own corpus. Not a single unified doctrine, pragmatism may be better described as a collection of positions which together form a coherent philosophical system. This paper examines three interrelated uses of the term: (1) pragmatism (...) as a temperament, (2) pragmatism as a philosophical method, and (3) pragmatism as a “humanistic” and “concrete” theory of knowledge and truth. Some critics infer that pragmatist truth is relative or subjective. This paper concludes with a consideration of James’s responses to such critics. Though James maintains truth is something both “made” and “satisfying,” he just as clearly affirms that as it develops, truth is ever constrained by the elements of extramental reality as well as previously vetted truths. This pragmatist truth is not a function of personal caprice, and the pragmatist is certainly not one who denies an objective order or bends the world to his wishes. (shrink)

Cognition means different things to different psychologists depending on the position held on the mind-matter problem. Ecological psychologists reject the implied mind-matter dualism as an ill-posed theoretic problem because the assumed mind-matter incommensurability precludes a solution to the degrees of freedom problem. This fundamental problem was posed by both Nicolai Bernstein and James J. Gibson independently. It replaces mind-matter dualism with animal-environment duality -- a better posed scientific problem because commensurability is assured. Furthermore, when properly posed this way, a (...) conservation law is suggested that encompasses a psychology of transactional systems, a biology of self-actional systems, and a physics of interactional systems. For such a solution, a theory of cognition for goal-directed behaviour is needed. A sketch is supplied for how such a theory might be pursued in the spirit of the new physics of evolving complex systems. (shrink)

We explore the various ethical challenges that arise during the practical implementation of an emergency resource allocation protocol. We argue that to implement an allocation plan in a crisis, a hospital system must complete five tasks: (1) formulate a set of general principles for allocation, (2) apply those principles to the disease at hand to create a concrete protocol, (3) collect the data required to apply the protocol, (4) construct a system to implement triage decisions with those data, and (5) (...) create a system for managing the consequences of implementing the protocol, including the effects on those who must carry out the plan, the medical staff, and the general public. Here we illustrate the complexities of each task and provide tentative solutions, by describing the experiences of the Coronavirus Ethics Response Group, an interdisciplinary team formed to address the ethical issues in pandemic resource planning at the University of Rochester Medical Center. While the plan was never put into operation, the process of preparing for emergency implementation exposed ethical issues that require attention. (shrink)

In the 1980s and 1990s the discipline of philosophy of education had an impact on schooling and the public service in New Zealand because of the contracted work of James Marshall and Michael Peters. This personal reflection by Robert Shaw is a tribute to James Marshall and provides insight into the relationship between Ministry officials, the community, and educational researchers.

In the 1980s and 1990s the discipline of philosophy of education had an impact on schooling and the public service in New Zealand because of the contracted work of James Marshall and Michael Peters. This personal reflection by Robert Shaw is a tribute to James Marshall and provides insight into the relationship between Ministry officials, the community, and educational researchers.

Course designers adopted a language-learners approach to the online teaching of New Zealand secondary school students in the subject of astronomy. This was possible because the curriculum for astronomy that was in 2004 established as a part of New Zealand's national curriculum was specifically designed to engage underachieving students in science and technology. A criterion-referenced assessment regime was established and an Internet platform was built specifically to facilitate this form of assessment. This platform contrasts with the norm-referenced assessment programmes that (...) are most frequently used with online instruction. In this situation - where the essential task is to reward students for learning basic vocabulary and to motivate them to further study - the theory of psychologist William James assisted the teachers to develop their online pedagogy. The article concludes with a comparison of the advantages and disadvantages of using the Internet to deliver science courses to secondary school students. (shrink)

This paper analyzes the following question: What do women deserve, ethically speaking, when they agree to gestate a fetus on behalf of third parties? I argue for several claims. First, I argue that gestational motherhood’s moral significance has been misunderstood, an oversight I attribute to the focus in family ethics on the conditions of parenthood. Second, I use a less controversial version of James Rachels’s account of desert to argue that gestational mothers deserve a parent-like voice as well as (...) significant care and support, conclusions that have implications for commercial surrogacy. Finally, I argue that we should not make requests of others when fulfilling them will lead others to deserve goods we cannot reasonably expect them to receive, and I conclude based on this thesis, what I call the “strings attached thesis,” that pro-life arguments in support of prohibitions on abortion commit their proponents to policies which they may not be willing to support. (shrink)